=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588656375
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CAPLAND CENTER FOR COMMUNICATION DISORDERS, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/17/2005
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3049 36TH ST
-----------------------------------------------------
City | PORT ARTHUR
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77642-5412
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 409-983-1651
-----------------------------------------------------
Fax | 409-983-1043
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3049 36TH ST
-----------------------------------------------------
City | PORT ARTHUR
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77642-5412
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 409-983-1651
-----------------------------------------------------
Fax | 409-983-1043
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | MRS. CAROL PATTESON HEBERT
-----------------------------------------------------
Credential | M.S.,CCC-SLP
-----------------------------------------------------
Telephone | 409-983-1651
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251V00000X
-----------------------------------------------------
Taxonomy Name | Voluntary or Charitable Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------