Provider Demographics
NPI:1346526811
Name:JOHNSON SCHUTTE CORP.
Entity Type:Organization
Organization Name:JOHNSON SCHUTTE CORP.
Other - Org Name:SUNSHINE SPEECH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHUTTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-509-9802
Mailing Address - Street 1:6350 LAUREL CANYON BLVD STE 257
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-3221
Mailing Address - Country:US
Mailing Address - Phone:818-509-9802
Mailing Address - Fax:818-509-8482
Practice Address - Street 1:6350 LAUREL CANYON BLVD STE 257
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-3221
Practice Address - Country:US
Practice Address - Phone:818-509-9802
Practice Address - Fax:818-509-8482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-28
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP12441235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASP12441OtherSTATE LICENSE OF THE OWNER THERAPIST