Provider Demographics
NPI:1790131258
Name:ACHEGWIN THERAPY SERVICES, INC
Entity Type:Organization
Organization Name:ACHEGWIN THERAPY SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SALAZAR
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:786-486-5184
Mailing Address - Street 1:7355 NW 173RD DR
Mailing Address - Street 2:101
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-8423
Mailing Address - Country:US
Mailing Address - Phone:786-486-5184
Mailing Address - Fax:
Practice Address - Street 1:7355 NW 173RD DR
Practice Address - Street 2:101
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-8423
Practice Address - Country:US
Practice Address - Phone:786-486-5184
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-13
Last Update Date:2016-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 13588235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty