Provider Demographics
NPI: | 1699966341 |
---|---|
Name: | THE CENTER FOR THERAPEUTIC LEARNING AND COMMUNICATION, PLLC |
Entity type: | Organization |
Organization Name: | THE CENTER FOR THERAPEUTIC LEARNING AND COMMUNICATION, PLLC |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | HR GENERALIST |
Authorized Official - Prefix: | |
Authorized Official - First Name: | SARAH |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | LANDRUM |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 586-421-4062 |
Mailing Address - Street 1: | 30330 HICKEY RD |
Mailing Address - Street 2: | |
Mailing Address - City: | CHESTERFIELD |
Mailing Address - State: | MI |
Mailing Address - Zip Code: | 48051-3911 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 586-421-4062 |
Mailing Address - Fax: | 586-421-4072 |
Practice Address - Street 1: | 30330 HICKEY RD |
Practice Address - Street 2: | |
Practice Address - City: | CHESTERFIELD |
Practice Address - State: | MI |
Practice Address - Zip Code: | 48051-3911 |
Practice Address - Country: | US |
Practice Address - Phone: | 586-421-4062 |
Practice Address - Fax: | 586-421-4072 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-08-07 |
Last Update Date: | 2024-01-12 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
103K00000X, 106S00000X, 2081P0010X, 224Z00000X, 224ZF0002X, 2251P0200X, 225XP0200X, 235Z00000X | ||
MI | 5201007130 | 261QR0400X |
MI | 261QR0400X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 261QR0400X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation | Group - Multi-Specialty |
No | 103K00000X | Behavioral Health & Social Service Providers | Behavior Analyst | Group - Multi-Specialty | |
No | 106S00000X | Behavioral Health & Social Service Providers | Behavior Technician | Group - Multi-Specialty | |
No | 2081P0010X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Pediatric Rehabilitation Medicine | Group - Multi-Specialty |
No | 224Z00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Group - Multi-Specialty | |
No | 224ZF0002X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Feeding, Eating & Swallowing | Group - Multi-Specialty |
No | 2251P0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Pediatrics | Group - Multi-Specialty |
No | 225XP0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Pediatrics | Group - Multi-Specialty |
No | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Multi-Specialty |