# BROAD HORIZONS SPEECH THERAPY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518505999
- **Authorized official:** CALONDA HENRY M.S. CCC-SLP (CEO AND FOUNDER)
- **Authorized official phone:** (904) 428-8302

## Contact information

- **Practice address:** 9191 R G SKINNER PKWY UNIT 103, JACKSONVILLE, FL 32256-9656
- **Practice address phone:** (904) 428-8302
- **Practice address fax:** (904) 456-0296
- **Mailing address:** 9191 R G SKINNER PKWY UNIT 103, JACKSONVILLE, FL 32256-9656
- **Mailing address phone:** (904) 428-8302
- **Mailing address fax:** (904) 456-0296

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 235Z00000X | Speech-Language Pathologist | — | NULL | Yes |
| 235Z00000X | Speech-Language Pathologist | — | — | Yes |

## Other

- **Enumeration date:** 12/16/2019
- **Last updated:** 05/24/2023