Provider Demographics
NPI:1710353735
Name:LANGUAGE & LEARNING CENTERS OF WELLESLEY HILLS LLC
Entity Type:Organization
Organization Name:LANGUAGE & LEARNING CENTERS OF WELLESLEY HILLS LLC
Other - Org Name:LANGUAGE & LEARNING CENTERS OF AMERICA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CROSBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:339-686-2640
Mailing Address - Street 1:30 WASHINGTON ST
Mailing Address - Street 2:STE 300
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02481-1905
Mailing Address - Country:US
Mailing Address - Phone:339-686-2640
Mailing Address - Fax:339-686-2639
Practice Address - Street 1:30 WASHINGTON ST
Practice Address - Street 2:STE 300
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481-1905
Practice Address - Country:US
Practice Address - Phone:339-686-2640
Practice Address - Fax:339-686-2639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-13
Last Update Date:2016-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110105263AOtherMASSHEALTH PIN
MAS100252381Medicare PIN