Provider Demographics
NPI:1548582091
Name:EXECUTIVE COMMUNICATIONS LLC
Entity Type:Organization
Organization Name:EXECUTIVE COMMUNICATIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIMMETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-720-3795
Mailing Address - Street 1:18976 N 92ND WAY
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-9254
Mailing Address - Country:US
Mailing Address - Phone:480-720-3795
Mailing Address - Fax:
Practice Address - Street 1:18976 N 92ND WAY
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-9254
Practice Address - Country:US
Practice Address - Phone:480-720-3795
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-25
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP1155235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ137433Medicare PIN
AZZ135841Medicare PIN
AZZ135842Medicare PIN