Provider Demographics
NPI:1164921995
Name:SPS DISABILITY SERVICES LLC
Entity Type:Organization
Organization Name:SPS DISABILITY SERVICES LLC
Other - Org Name:SPSDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:BINYOMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MANDELBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-961-8458
Mailing Address - Street 1:100 BOULEVARD OF THE AMERICAS
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-4585
Mailing Address - Country:US
Mailing Address - Phone:732-961-8458
Mailing Address - Fax:
Practice Address - Street 1:100 BOULEVARD OF THE AMERICAS
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-4585
Practice Address - Country:US
Practice Address - Phone:732-961-8458
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-07
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management