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General NPI Number Information
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NPI Number | 1598928194
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Entity Type | Organization
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Legal Business Name | LITCHFIELD PARK SPEECH SERVICES, L.L.C.
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Dates
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Enumeration Date | 07/03/2008
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Last Update Date | 07/03/2008
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Provider Practice Location Address
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Address Line | 12411 W RANCHO DR
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City | LITCHFIELD PARK
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State | AZ
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Zip | 85340-3493
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Country | US
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Telephone | 623-535-9553
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Fax |
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Provider Business Mailing Address
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Address Line | 12411 W RANCHO DR
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City | LITCHFIELD PARK
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State | AZ
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Zip | 85340-3493
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Country | US
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Telephone | 623-535-9553
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MARTY JOYNER
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Credential | M.S., CCC-SLP
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Telephone | 623-535-9553
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 4201
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License Number State | AZ
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