Provider Demographics
NPI:1245520105
Name:LIVINGSTON ENTERPRISES INC
Entity type:Organization
Organization Name:LIVINGSTON ENTERPRISES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:LIVINGSTON
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC-SLP
Authorized Official - Phone:719-442-6653
Mailing Address - Street 1:2917 MESA RD
Mailing Address - Street 2:#A
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80904-8121
Mailing Address - Country:US
Mailing Address - Phone:719-442-6653
Mailing Address - Fax:719-623-0600
Practice Address - Street 1:5040 CORPORATE PLAZA DR
Practice Address - Street 2:SUITE 8
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-3132
Practice Address - Country:US
Practice Address - Phone:719-442-6653
Practice Address - Fax:719-623-0600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-12
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0300094235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty