Provider Demographics
NPI:1922442078
Name:CODY EDUCATIONAL ENTERPRISES, INC.
Entity Type:Organization
Organization Name:CODY EDUCATIONAL ENTERPRISES, INC.
Other - Org Name:BIG SPRINGS EDUATIONAL THERAPY CENTER & SCHOOL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HUTCH
Authorized Official - Suffix:
Authorized Official - Credentials:SPECIAL EDUATION MA
Authorized Official - Phone:951-488-0404
Mailing Address - Street 1:41769 ENTERPRISE CIRCLE NORTH
Mailing Address - Street 2:SUITE 101
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592
Mailing Address - Country:US
Mailing Address - Phone:951-488-0404
Mailing Address - Fax:951-488-0411
Practice Address - Street 1:41769 ENTERPRISE CIRCLE NORTH
Practice Address - Street 2:SUITE 101
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592
Practice Address - Country:US
Practice Address - Phone:951-488-0404
Practice Address - Fax:951-488-0411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-19
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3427103T00000X
CASPA4262355S0801X
CASP1650235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Single Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty