Provider Demographics
NPI:1528680527
Name:SPEECH JUNGLE LLC
Entity type:Organization
Organization Name:SPEECH JUNGLE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:REEDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-410-4881
Mailing Address - Street 1:8660 BRENTWOOD BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-5671
Mailing Address - Country:US
Mailing Address - Phone:925-626-7474
Mailing Address - Fax:925-420-6190
Practice Address - Street 1:8660 BRENTWOOD BLVD STE C
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:CA
Practice Address - Zip Code:94513-5671
Practice Address - Country:US
Practice Address - Phone:925-626-7474
Practice Address - Fax:925-420-6190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-12
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine