Provider Demographics
NPI:1437597762
Name:SPECTRUM THERAPY CENTER, INC.
Entity Type:Organization
Organization Name:SPECTRUM THERAPY CENTER, INC.
Other - Org Name:SPECTRUM THERAPY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:BURKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-709-8948
Mailing Address - Street 1:180 JACKSON PLZ
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-1959
Mailing Address - Country:US
Mailing Address - Phone:734-769-0505
Mailing Address - Fax:734-769-0797
Practice Address - Street 1:180 JACKSON PLZ
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-1959
Practice Address - Country:US
Practice Address - Phone:734-769-0505
Practice Address - Fax:734-769-0797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-09
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty