Provider Demographics
NPI:1972197473
Name:CASCADA RESILIENT THERAPY PLLC
Entity Type:Organization
Organization Name:CASCADA RESILIENT THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO & TREATING SLP
Authorized Official - Prefix:
Authorized Official - First Name:LEXI
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:832-270-4321
Mailing Address - Street 1:1801 E 51ST ST
Mailing Address - Street 2:SUITE 365 #239
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723
Mailing Address - Country:US
Mailing Address - Phone:512-661-7971
Mailing Address - Fax:
Practice Address - Street 1:1109 E 5TH ST APT 1257
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78702-3895
Practice Address - Country:US
Practice Address - Phone:512-661-7971
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-24
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health