BLUE WATER SPEECH THERAPY


Address: 7950 Caberfae Trl, Clarkston, MI 48348-3707
Phone: 2517672597

BLUE WATER SPEECH THERAPY (NPI# 1194230888) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1194230888
Entity Type Organization
Organization Name BLUE WATER SPEECH THERAPY
Practice Address 7950 Caberfae Trl
Clarkston
MI 48348-3707
Practice Telephone 2517672597
Mailing Telephone 2517672597
Enumeration Date 2017-12-05
Last Update Date 2017-12-05
Authorized Official Name HEATHER REYNOLDS (PRESIDENT)
Authorized Official Telephone 2517672597
Authorized Official Credential SLP
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QR0400X Clinic/Center
Specialization: Rehabilitation
7101005105 MI Ambulatory Health Care Facilities

Office Location

Street Address 7950 CABERFAE TRL
City CLARKSTON
State MI
Zip Code 48348-3707

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1447587753 Carrie Ann Schlicht Occupational Therapist 7508 Mecad Boulevard, Suite A, Clarkston, MI 48348 2009-11-06
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1467600528 Brian Davidson Dds PC Dentist 5720 Clarkston Road, Clarkston, MI 48348 2008-09-03
1962624957 Keri Sue Hickmott Social Worker 9340 Dixie Highway, Clarkston, MI 48348 2007-05-02
1720209273 Linda Carole Gualdoni Physical Therapist 7508 M.e. Cad Blvd., Suite A, Clarkston, MI 48348 2007-05-01
1396964466 David William Regiani Dentist 10435 Ortonville Road, Suite B, Clarkston, MI 48348 2007-04-25
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Taxonomy Information

Taxonomy Code 261QR0400X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Rehabilitation

Taxonomy Definition

Definition to come...

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1013566199 J.l Hunt Therapeutics Clinic/Center 43700 Woodward Ave Ste 108, Bloomfield Hills, MI 48302-5060 2019-09-10
1548828502 Chsc Inc Clinic/Center 10125 W 8 Mile Rd, Detroit, MI 48221-1004 2019-06-04
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1366934184 Rehabcare Group East, LLC Clinic/Center 1300 N Telegraph Rd, Dearborn, MI 48128-1204 2018-06-06
1902305048 Nrmi, LLC Clinic/Center 14461 E 11 Mile Rd, Warren, MI 48088-4886 2018-02-05
1093236291 Genesis Eldercare Rehabilitation Services LLC Clinic/Center 1620 S Mission St Ste O, Mt Pleasant, MI 48858-4466 2017-06-28
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Competitor

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City CLARKSTON
Zip Code 48348

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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