Provider Demographics
NPI:1376092742
Name:SPOTLIGHT THERAPY, INC.
Entity Type:Organization
Organization Name:SPOTLIGHT THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:BRANDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-649-7349
Mailing Address - Street 1:600 PENNSYLVANIA AVE UNIT 30
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95030-5860
Mailing Address - Country:US
Mailing Address - Phone:408-649-7349
Mailing Address - Fax:408-628-1302
Practice Address - Street 1:600 PENNSYLVANIA AVE UNIT 30
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95030-5860
Practice Address - Country:US
Practice Address - Phone:408-649-7349
Practice Address - Fax:408-628-1302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-27
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No252Y00000XAgenciesEarly Intervention Provider Agency