Provider Demographics
NPI:1043835358
Name:ALLIANCE FOR SPEECH AND SWALLOWING REHABILITATION LLC
Entity type:Organization
Organization Name:ALLIANCE FOR SPEECH AND SWALLOWING REHABILITATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERMETRA
Authorized Official - Middle Name:RENA DELAINE
Authorized Official - Last Name:PAYTON
Authorized Official - Suffix:
Authorized Official - Credentials:MCD, CCC-SLP
Authorized Official - Phone:256-684-2124
Mailing Address - Street 1:103 SPENRYN DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-1891
Mailing Address - Country:US
Mailing Address - Phone:256-684-2124
Mailing Address - Fax:888-928-1029
Practice Address - Street 1:103 SPENRYN DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-1891
Practice Address - Country:US
Practice Address - Phone:256-642-6495
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-11
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty