Provider Demographics
NPI:1912671330
Name:JOURNEY THERAPY CENTER LLC
Entity Type:Organization
Organization Name:JOURNEY THERAPY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:LEANDRES
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA, LBA
Authorized Official - Phone:810-358-0373
Mailing Address - Street 1:1100 W NEWARK RD
Mailing Address - Street 2:
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446-9449
Mailing Address - Country:US
Mailing Address - Phone:810-358-0373
Mailing Address - Fax:810-678-3204
Practice Address - Street 1:1100 W NEWARK RD
Practice Address - Street 2:
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-9449
Practice Address - Country:US
Practice Address - Phone:810-358-0373
Practice Address - Fax:810-678-3204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-09
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty