Provider Demographics
NPI:1548313315
Name:RIVER SPEECH AND EDUCATIONAL SERVICES, INC
Entity type:Organization
Organization Name:RIVER SPEECH AND EDUCATIONAL SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:CHERIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:RIVER
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC SLP
Authorized Official - Phone:412-767-5967
Mailing Address - Street 1:3390 SAXONBURG BLVD.
Mailing Address - Street 2:SUITE 250
Mailing Address - City:GLENSHAW
Mailing Address - State:PA
Mailing Address - Zip Code:15116
Mailing Address - Country:US
Mailing Address - Phone:412-767-5967
Mailing Address - Fax:412-767-5960
Practice Address - Street 1:3390 SAXONBURG BLVD.
Practice Address - Street 2:SUITE 250
Practice Address - City:GLENSHAW
Practice Address - State:PA
Practice Address - Zip Code:15116
Practice Address - Country:US
Practice Address - Phone:412-767-5967
Practice Address - Fax:412-767-5960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QH0700X, 261QP2000X, 261QX0100X
PASL0006123L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and SpeechGroup - Single Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1020417940002Medicaid
PASL0006123LOtherSPEECH THERAPIST LICENSE