Basic Information
| Provider Information | |||||||||
| NPI: | 1265658215 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | COMMUNICATION MADE EASY INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 151 SOUTHWEST DR | ||||||||
| Address2: | |||||||||
| City: | JONESBORO | ||||||||
| State: | AR | ||||||||
| PostalCode: | 724015828 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8709306358 | ||||||||
| FaxNumber: | 8709309336 | ||||||||
| Practice Location | |||||||||
| Address1: | 151 SOUTHWEST DR | ||||||||
| Address2: | |||||||||
| City: | JONESBORO | ||||||||
| State: | AR | ||||||||
| PostalCode: | 724015828 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8709306358 | ||||||||
| FaxNumber: | 8709309336 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/18/2007 | ||||||||
| LastUpdateDate: | 07/13/2011 | ||||||||
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| AuthorizedOfficialLastName: | POTTS | ||||||||
| AuthorizedOfficialFirstName: | NICOLE | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8709306372 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 222Q00000X | N | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Developmental Therapist | 235Z00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
ID Information
| ID | Type | State | Issuer | Description | 5F308 | 01 | AR | BCBS NUMBER | OTHER | 155837742 | 05 | AR | MEDICAID |