Life Speech Services PLLC
Organization Active NPI Speech-Language Pathologist · Burnham, PA
NPI 1013683929 · NPPES record last updated Aug 19, 2021
Key facts
- NPI
- 1013683929
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- Legal business name
- LIFE SPEECH SERVICES PLLC
- Practice address
- 202 5TH Ave
Burnham, PA 17009-1616 - Phone
- (484) 663-3693
- NPI assigned
- Aug 19, 2021
- Organization subpart
- No
Authorized official
- Name
- Mrs. Rebecca Kruise, M.S. CCC-SLP
- Title
- Owner/SLP
- Phone
- (484) 663-3693
Practitioners 1
-
Rebecca Lynn Kruise, M.S. CCC-SLP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20211005003131 | PA | Part B Supplier - Clinic/Group Practice | 2264830264 |
Receives reassigned benefits from 1 practitioner Practice locations: Burnham, PA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist |
235Z00000X | Yes |
Addresses
Primary practice location
202 5TH Ave
Burnham, PA 17009-1616
Mailing address
202 5TH Ave
Burnham, PA 17009-1616
Phone (484) 663-3693
Other names
- Life Speech Services
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All providers in Burnham, PA · Speech-Language Pathologist in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 19, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.