Provider Demographics
NPI:1154088623
Name:GUIDED SPECTRUM-A BEHAVIORAL THERAPY GROUP LLC
Entity Type:Organization
Organization Name:GUIDED SPECTRUM-A BEHAVIORAL THERAPY GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRCTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JAHMOIA
Authorized Official - Middle Name:MONIQUE
Authorized Official - Last Name:RICE-NORFLETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-984-8284
Mailing Address - Street 1:311 W SYLVANIA AVE APT 272A
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-5902
Mailing Address - Country:US
Mailing Address - Phone:732-984-8284
Mailing Address - Fax:
Practice Address - Street 1:311 W SYLVANIA AVE APT 272A
Practice Address - Street 2:
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-5902
Practice Address - Country:US
Practice Address - Phone:732-984-8284
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-19
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral Health
No252Y00000XAgenciesEarly Intervention Provider Agency
No253Z00000XAgenciesIn Home Supportive Care
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment FacilityGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1154982791Medicaid