Provider Demographics
NPI:1386466480
Name:THE BRECKENRIDGE COMPANY
Entity type:Organization
Organization Name:THE BRECKENRIDGE COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KEELEY
Authorized Official - Middle Name:
Authorized Official - Last Name:STEMPIN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:313-655-0339
Mailing Address - Street 1:44359 MANITOU DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-4434
Mailing Address - Country:US
Mailing Address - Phone:313-655-0339
Mailing Address - Fax:
Practice Address - Street 1:44359 MANITOU DR
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-4434
Practice Address - Country:US
Practice Address - Phone:313-655-0339
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE BRECKENRIDGE COMPANY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-10-29
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty