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Organization
VAST GROWTH
Active
Organization
VAST GROWTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATESHA RANDELL COPELAND (FOUNDER)
(516) 289-2574
Entity
Organization
Contact information
Practice address
580 LEONARD AVE, UNIONDALE, NY 11553-2524
(516) 289-2574
Mailing address
PO BOX 436, UNIONDALE, NY 11553-0436
Taxonomy
Speciality
Code
Description
License number
State
171R00000X
Interpreter
—
—
261QH0700X
Hearing and Speech Clinic/Center
Primary
—
—
Other
Enumeration date
12/15/2020
Last updated
12/15/2020
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