| Spectrum Behavioral Services Llc | |
|
418 E Mishawaka Ave Mishawaka IN 46545-6820 | |
| (574) 855-3571 | |
| Not Available |
| Full Name | Spectrum Behavioral Services Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 418 E Mishawaka Ave, Mishawaka, Indiana |
| Authorized Official Name and Position | Amanda Dorman (OWNER) |
| Authorized Official Contact | 5748553571 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Spectrum Behavioral Services Llc 418 E Mishawaka Ave Mishawaka IN 46545-6820 Ph: (574) 855-3571 | Spectrum Behavioral Services Llc 418 E Mishawaka Ave Mishawaka IN 46545-6820 Ph: (574) 855-3571 |
| NPI Number | 1548858160 |
|---|---|
| Provider Enumeration Date | 01/08/2021 |
| Last Update Date | 01/08/2021 |
| Certification Date | 01/08/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548858160 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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