Provider Demographics
NPI:1780687095
Name:ABBY D CENTER, INC.
Entity Type:Organization
Organization Name:ABBY D CENTER, INC.
Other - Org Name:THE SPEECH AND SWALLOW CENTER, NORTHERN MICHIGAN SLP'S
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:ELISABETH
Authorized Official - Last Name:LENKEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:231-348-7777
Mailing Address - Street 1:2206 MITCHELL PARK DR
Mailing Address - Street 2:STE 14
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-8674
Mailing Address - Country:US
Mailing Address - Phone:231-348-7777
Mailing Address - Fax:231-348-3177
Practice Address - Street 1:2206 MITCHELL PARK DR
Practice Address - Street 2:STE 14
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-8674
Practice Address - Country:US
Practice Address - Phone:231-348-7777
Practice Address - Fax:231-348-3177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-31
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI225100000X, 225700000X, 225X00000X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
00973297OtherASHA
00973297OtherASHA