Provider Demographics
NPI:1578687612
Name:SPECTRUM HUMAN SERVICES,INC
Entity Type:Organization
Organization Name:SPECTRUM HUMAN SERVICES,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT,CEOT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:I
Authorized Official - Last Name:SWANINGER
Authorized Official - Suffix:
Authorized Official - Credentials:ACSW,MSW
Authorized Official - Phone:734-458-8736
Mailing Address - Street 1:28303 JOY RD
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185-5524
Mailing Address - Country:US
Mailing Address - Phone:734-458-8736
Mailing Address - Fax:734-458-8836
Practice Address - Street 1:7430 2ND AVE
Practice Address - Street 2:SUITE 900
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-2739
Practice Address - Country:US
Practice Address - Phone:313-456-6000
Practice Address - Fax:313-935-9911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI821956251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health