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General NPI Number Information
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NPI Number | 1043468960
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Entity Type | Organization
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Legal Business Name | HOME CENTERED SPEECH SERVICES
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Dates
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Enumeration Date | 09/04/2008
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Last Update Date | 10/06/2011
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Provider Practice Location Address
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Address Line | 301 ELBERTA STREET
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City | LAMAR
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State | AR
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Zip | 72846-8100
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Country | US
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Telephone | 501-733-8314
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Fax |
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Provider Business Mailing Address
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Address Line | 107 HIGHWAY 300
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City | PERRYVILLE
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State | AR
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Zip | 72126-8213
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Country | US
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Telephone | 501-733-8314
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Fax |
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Authorized Official
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Title or Position | SLP
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Name | BEVERLY J EARLS
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Credential |
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Telephone | 501-733-8314
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | 787
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 787
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License Number State | AR
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