Provider Demographics
NPI:1114235843
Name:SPECTRUM THERAPEUTIC SERVICES, INC.
Entity Type:Organization
Organization Name:SPECTRUM THERAPEUTIC SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANTUANETE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAVEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-439-7818
Mailing Address - Street 1:1451 W CYPRESS CREEK RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-1914
Mailing Address - Country:US
Mailing Address - Phone:954-439-7818
Mailing Address - Fax:
Practice Address - Street 1:1451 W CYPRESS CREEK RD
Practice Address - Street 2:SUITE 300
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-1914
Practice Address - Country:US
Practice Address - Phone:954-439-7818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-15
Last Update Date:2016-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health