Provider Demographics
NPI:1649628207
Name:NEW HEIGHTS SPEECH & LANGUAGE THERAPY, LLC
Entity type:Organization
Organization Name:NEW HEIGHTS SPEECH & LANGUAGE THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LILY
Authorized Official - Middle Name:
Authorized Official - Last Name:CAYWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-830-1092
Mailing Address - Street 1:9700 W. STATE STREET
Mailing Address - Street 2:
Mailing Address - City:STAR
Mailing Address - State:ID
Mailing Address - Zip Code:83669-5766
Mailing Address - Country:US
Mailing Address - Phone:208-830-1092
Mailing Address - Fax:208-545-7505
Practice Address - Street 1:9700 W. STATE STREET
Practice Address - Street 2:
Practice Address - City:STAR
Practice Address - State:ID
Practice Address - Zip Code:83669-5766
Practice Address - Country:US
Practice Address - Phone:208-830-1092
Practice Address - Fax:208-545-7505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-24
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDSLP-2399235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty