Provider Demographics
NPI:1669483210
Name:SPEECH CONNECTIONS, LLC
Entity Type:Organization
Organization Name:SPEECH CONNECTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GRANT MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:J
Authorized Official - Last Name:MCRAE
Authorized Official - Suffix:
Authorized Official - Credentials:NA
Authorized Official - Phone:910-295-2609
Mailing Address - Street 1:PO BOX 4177
Mailing Address - Street 2:
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-4177
Mailing Address - Country:US
Mailing Address - Phone:910-295-2609
Mailing Address - Fax:910-295-0026
Practice Address - Street 1:650 PAGE ST.
Practice Address - Street 2:SUITE D
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-4177
Practice Address - Country:US
Practice Address - Phone:910-295-2609
Practice Address - Fax:910-295-0026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7211218Medicaid
NC014K8OtherBCBS