Divine Intervention Speech-Language Therapy Services, LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

DIVINE INTERVENTION SPEECH-LANGUAGE THERAPY SERVICES, LLC

Practice address

108 S Highway 135
Suite a
Lakeland, GA 31635-6356

Phone

(229) 560-1135

Fax

(229) 455-2099

NPI assigned

Aug 15, 2014

Last updated

Aug 15, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Keisha BanksNPI 1740346949

Title

Owner

Phone

(229) 560-1135

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Keisha Banks

  • Speech-Language Pathologist
  • Lakeland, GA
  • NPI 1740346949
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1408060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408060800000",
    "number": "1083013023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 431",
            "city": "LAKELAND",
            "state": "GA",
            "postal_code": "316350431",
            "telephone_number": "229-560-1135",
            "fax_number": "229-455-2099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 S HIGHWAY 135",
            "address_2": "SUITE A",
            "city": "LAKELAND",
            "state": "GA",
            "postal_code": "316356356",
            "telephone_number": "229-560-1135",
            "fax_number": "229-455-2099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE INTERVENTION SPEECH-LANGUAGE THERAPY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-15",
        "last_updated": "2014-08-15",
        "status": "A",
        "authorized_official_last_name": "BANKS",
        "authorized_official_first_name": "KEISHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "229-560-1135"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Lakeland, GA
• Providers in Lakeland, GA by specialty
• Speech-Language Pathologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.