MEDICARE: COMMUNICATION AND FEEDING SPECIALISTS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QH0700X	Hearing and Speech Clinic/Center

General Provider Information

NPI Number	:	1548827249
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNICATION AND FEEDING SPECIALISTS LLC

Provider Business Mailing Address
First Line	:	1354 N 65TH ST
Second Line	:
City	:	WAUWATOSA
State	:	WI
Zip	:	53213-2972
Country	:	US
Telephone Number	:	414-807-7512
Fax Number	:

Provider Business Practice Location Address
First Line	:	8707 W NORTH AVE
Second Line	:
City	:	WAUWATOSA
State	:	WI
Zip	:	53226-2723
Country	:	US
Telephone Number	:	414-208-0753
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JORDAN BECK
Credential	:
Telephone Number	:	414-807-7512

Provider Enumeration Date	:	05/29/2019
Last Update Date	:	05/29/2019

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