Provider Demographics
NPI:1609287903
Name:LANGUAGE LINK THERAPY II, LLC
Entity Type:Organization
Organization Name:LANGUAGE LINK THERAPY II, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MBR
Authorized Official - Prefix:MS
Authorized Official - First Name:ILENE
Authorized Official - Middle Name:R
Authorized Official - Last Name:ROTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:954-644-8898
Mailing Address - Street 1:7621 VENTURA LN
Mailing Address - Street 2:NONE
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33067-2302
Mailing Address - Country:US
Mailing Address - Phone:954-644-8898
Mailing Address - Fax:877-811-2570
Practice Address - Street 1:7621 VENTURA LN
Practice Address - Street 2:NONE
Practice Address - City:PARKLAND
Practice Address - State:FL
Practice Address - Zip Code:33067-2302
Practice Address - Country:US
Practice Address - Phone:954-644-8898
Practice Address - Fax:877-811-2570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-08
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT11230225XP0200X
FLSA8817235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL011684900Medicaid