Provider Demographics
NPI:1144576406
Name:SPECTRUM HOME CARE
Entity Type:Organization
Organization Name:SPECTRUM HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:MICHELE
Authorized Official - Last Name:ARCHER-ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:215-596-9399
Mailing Address - Street 1:6535 N LAMBERT ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19138-3112
Mailing Address - Country:US
Mailing Address - Phone:215-596-9399
Mailing Address - Fax:
Practice Address - Street 1:6535 N LAMBERT ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19138-3112
Practice Address - Country:US
Practice Address - Phone:215-596-9399
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA23123601253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care