Provider Demographics
NPI:1063012599
Name:ACROSS THE SPECTRUM LLC
Entity Type:Organization
Organization Name:ACROSS THE SPECTRUM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BCBA, OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:KIRSTEN
Authorized Official - Last Name:FELLER
Authorized Official - Suffix:
Authorized Official - Credentials:MED, BCBA
Authorized Official - Phone:260-667-7471
Mailing Address - Street 1:7055 E STATE ROAD 120
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:IN
Mailing Address - Zip Code:46737-9520
Mailing Address - Country:US
Mailing Address - Phone:260-667-7471
Mailing Address - Fax:833-832-1431
Practice Address - Street 1:7055 E STATE ROAD 120
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:IN
Practice Address - Zip Code:46737-9520
Practice Address - Country:US
Practice Address - Phone:260-667-7471
Practice Address - Fax:833-832-1431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty