Provider Demographics
NPI:1558409763
Name:SPEECH CARE, INC.
Entity Type:Organization
Organization Name:SPEECH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED AGENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:ROBERTS
Authorized Official - Last Name:HENDRIX
Authorized Official - Suffix:
Authorized Official - Credentials:MEDSLP
Authorized Official - Phone:706-356-8296
Mailing Address - Street 1:891 N FAIRVIEW RD
Mailing Address - Street 2:
Mailing Address - City:LAVONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30553-3317
Mailing Address - Country:US
Mailing Address - Phone:706-356-8296
Mailing Address - Fax:706-384-3727
Practice Address - Street 1:891 N FAIRVIEW RD
Practice Address - Street 2:
Practice Address - City:LAVONIA
Practice Address - State:GA
Practice Address - Zip Code:30553-3317
Practice Address - Country:US
Practice Address - Phone:706-356-8296
Practice Address - Fax:706-384-3727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP001494235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty