| Organization Name: | HIGH PEAKS REHAB & DEVEL CENTER |
| NPI Number: | 1245258607 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JUDITH D SWANSON (OWNER) |
| Mailing Address: | 170 Intrepid Ln Syracuse |
| State: | NY US |
| Postal Code: | 132052545 |
| Phone Number: | 3154928319 |
| Fax Number: | 3154923758 |
| NPI Enumeration Date: | 07/17/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 0014191 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | NY |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |