Provider Demographics
NPI:1043645443
Name:BEYOND WORDS SPEECH THERAPY LLC
Entity type:Organization
Organization Name:BEYOND WORDS SPEECH THERAPY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:G
Authorized Official - Last Name:LANE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:828-287-1001
Mailing Address - Street 1:PO BOX 1749
Mailing Address - Street 2:
Mailing Address - City:FOREST CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28043-1749
Mailing Address - Country:US
Mailing Address - Phone:828-287-1001
Mailing Address - Fax:828-229-3332
Practice Address - Street 1:671 OAK ST STE 2
Practice Address - Street 2:
Practice Address - City:FOREST CITY
Practice Address - State:NC
Practice Address - Zip Code:28043-2440
Practice Address - Country:US
Practice Address - Phone:828-287-1001
Practice Address - Fax:828-229-3332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-05
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7200375Medicaid