Organization
GEENSIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARA CLOUD SLP (SPEECH LANGUAGE PATHOLOGIST)
(610) 998-9212
Entity
Organization
Contact information
Practice address
239 BLACK RD, QUARRYVILLE, PA 17566-9642
(302) 250-5682
Mailing address
239 BLACK RD, QUARRYVILLE, PA 17566-9642
(302) 250-5682
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
SL008798
PA
Other
Enumeration date
02/20/2014
Last updated
02/20/2014
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