Provider Demographics
NPI:1649990847
Name:HYDE & GO SPEAK
Entity type:Organization
Organization Name:HYDE & GO SPEAK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MECHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MSLP
Authorized Official - Phone:208-721-0086
Mailing Address - Street 1:PO BOX 262
Mailing Address - Street 2:
Mailing Address - City:CAREY
Mailing Address - State:ID
Mailing Address - Zip Code:83320-0262
Mailing Address - Country:US
Mailing Address - Phone:208-721-0086
Mailing Address - Fax:208-823-4587
Practice Address - Street 1:120 LITTLE WOOD RESERVOIR RD.
Practice Address - Street 2:
Practice Address - City:CAREY
Practice Address - State:ID
Practice Address - Zip Code:83320
Practice Address - Country:US
Practice Address - Phone:208-823-4587
Practice Address - Fax:208-823-4587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech