Provider Demographics
NPI:1386697894
Name:CSB AUDIO REHABILITATION INC.
Entity type:Organization
Organization Name:CSB AUDIO REHABILITATION INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:I
Authorized Official - Last Name:BLACKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:BC-HIS,ACA
Authorized Official - Phone:352-589-4327
Mailing Address - Street 1:10601 US HIGHWAY 441
Mailing Address - Street 2:SUITE E1
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34788-7237
Mailing Address - Country:US
Mailing Address - Phone:352-315-8400
Mailing Address - Fax:352-315-8488
Practice Address - Street 1:10601 US HIGHWAY 441
Practice Address - Street 2:E1
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34788-7237
Practice Address - Country:US
Practice Address - Phone:352-315-8400
Practice Address - Fax:352-315-8488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty