Provider Demographics
NPI:1346399557
Name:SPECTRUM THERAPEUTIC ENTERPRISES, LLP
Entity Type:Organization
Organization Name:SPECTRUM THERAPEUTIC ENTERPRISES, LLP
Other - Org Name:BUILDING BLOCKS REHABILITATION & AUTISM CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:E
Authorized Official - Last Name:MENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-686-8485
Mailing Address - Street 1:5013 S MCCOLL RD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-8080
Mailing Address - Country:US
Mailing Address - Phone:956-686-8485
Mailing Address - Fax:956-686-8489
Practice Address - Street 1:5013 S MCCOLL RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-8080
Practice Address - Country:US
Practice Address - Phone:956-686-8485
Practice Address - Fax:956-686-8489
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X, 225XP0200X, 235Z00000X, 261QR0400X
TX552280000(OT)6549100261QR0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX167245302Medicaid