Provider Demographics
NPI:1922888197
Name:SPEECH AND LANGUAGE DEVELOPMENT CENTER
Entity Type:Organization
Organization Name:SPEECH AND LANGUAGE DEVELOPMENT CENTER
Other - Org Name:SPEECH AND LANGUAGE DEVELOPMENT CENTER INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:DARREN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-821-3620
Mailing Address - Street 1:43385 BUSINESS PARK DR STE 140
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-5517
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:714-821-5683
Practice Address - Street 1:43385 BUSINESS PARK DR STE 140
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-5517
Practice Address - Country:US
Practice Address - Phone:951-383-8505
Practice Address - Fax:714-821-5683
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SPEECH AND LANGUAGE DEVELOPMENT CENTER - TEMECULA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-10-04
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine