Provider Demographics
NPI:1922555044
Name:SPECTRUM OF HOPE, LLC
Entity type:Organization
Organization Name:SPECTRUM OF HOPE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROGRAM DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RHIANNON
Authorized Official - Middle Name:VICTORIA
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:BS, MS
Authorized Official - Phone:724-612-2900
Mailing Address - Street 1:11407 MEADOWLARK DR
Mailing Address - Street 2:
Mailing Address - City:IJAMSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21754-8917
Mailing Address - Country:US
Mailing Address - Phone:240-630-4673
Mailing Address - Fax:
Practice Address - Street 1:11407 MEADOWLARK DR
Practice Address - Street 2:
Practice Address - City:IJAMSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21754-8917
Practice Address - Country:US
Practice Address - Phone:240-630-4673
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-07
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health