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General NPI Number Information
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NPI Number | 1083082325
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Entity Type | Organization
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Legal Business Name | NORTHLAND HEARING CENTERS, INC.
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Dates
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Enumeration Date | 09/03/2015
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Last Update Date | 09/03/2015
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Provider Practice Location Address
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Address Line | 3907 CALUMET AVE SUITE 201
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City | VALPARAISO
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State | IN
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Zip | 46383-2269
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Country | US
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Telephone | 219-462-6866
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Fax | 219-462-9369
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Provider Business Mailing Address
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Address Line | 1001 E. SUNSET ROAD UNIT 96595
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City | LAS VEGAS
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State | NV
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Zip | 89193-1246
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Country | US
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Telephone | 702-798-0113
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Fax | 866-291-5242
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Authorized Official
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Title or Position | PRESIDENT
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Name | JEFFREY LONGTAIN
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Credential |
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Telephone | 702-798-0113
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332S00000X
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Taxonomy Name | Hearing Aid Equipment
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License Number |
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License Number State |
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