Provider Demographics
NPI:1508156902
Name:SPECTRUM RESOURCES OF NC INC.
Entity Type:Organization
Organization Name:SPECTRUM RESOURCES OF NC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CRISTINA
Authorized Official - Middle Name:H
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:QP
Authorized Official - Phone:919-906-9404
Mailing Address - Street 1:PO BOX 1111
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-1111
Mailing Address - Country:US
Mailing Address - Phone:919-906-9404
Mailing Address - Fax:919-238-4541
Practice Address - Street 1:100 BIG LAUREL CT
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540-7931
Practice Address - Country:US
Practice Address - Phone:919-906-9404
Practice Address - Fax:919-238-4541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-19
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)