Provider Demographics
NPI:1245975564
Name:SPEECH LANGUAGE CENTERS LLC
Entity type:Organization
Organization Name:SPEECH LANGUAGE CENTERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GRANT
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHAFLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-499-1164
Mailing Address - Street 1:15245 SHADY GROVE RD STE 110
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-7202
Mailing Address - Country:US
Mailing Address - Phone:678-889-0045
Mailing Address - Fax:
Practice Address - Street 1:1591 PORT REPUBLIC RD
Practice Address - Street 2:
Practice Address - City:ROCKINGHAM
Practice Address - State:VA
Practice Address - Zip Code:22801-3517
Practice Address - Country:US
Practice Address - Phone:678-889-0045
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-02
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral PediatricsGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty