Provider Demographics
NPI:1457620163
Name:ACADEMY FOR SPEECH AND LANGUAGE AT HOME LLC
Entity Type:Organization
Organization Name:ACADEMY FOR SPEECH AND LANGUAGE AT HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURI
Authorized Official - Middle Name:
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-207-0301
Mailing Address - Street 1:6701 SANGER AVE
Mailing Address - Street 2:STE. 102
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76710-7736
Mailing Address - Country:US
Mailing Address - Phone:254-207-0301
Mailing Address - Fax:254-207-0298
Practice Address - Street 1:6701 SANGER AVE
Practice Address - Street 2:STE. 102
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76710-7736
Practice Address - Country:US
Practice Address - Phone:254-207-0301
Practice Address - Fax:254-207-0298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-26
Last Update Date:2011-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health