Provider Demographics
NPI:1659411973
Name:SPECTRUM OF MARTIN COUNTY, LTD
Entity Type:Organization
Organization Name:SPECTRUM OF MARTIN COUNTY, LTD
Other - Org Name:SPECTRUM HOME HEALTH CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:LACY
Authorized Official - Last Name:DAWES
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:252-795-5886
Mailing Address - Street 1:POST OFFICE BOX 1659
Mailing Address - Street 2:103 RAILROAD STREET
Mailing Address - City:ROBERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27871-1659
Mailing Address - Country:US
Mailing Address - Phone:252-795-5886
Mailing Address - Fax:252-795-5886
Practice Address - Street 1:103 RAILROAD ST
Practice Address - Street 2:
Practice Address - City:ROBERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:27871-1659
Practice Address - Country:US
Practice Address - Phone:252-795-5886
Practice Address - Fax:252-795-5886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)