Provider Demographics
NPI:1457698755
Name:SPECTRUM COMMUNITY SERVICES, INC.
Entity Type:Organization
Organization Name:SPECTRUM COMMUNITY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:A
Authorized Official - Last Name:GERBER
Authorized Official - Suffix:
Authorized Official - Credentials:MS,RN, BC
Authorized Official - Phone:610-717-5722
Mailing Address - Street 1:2921 WINDMILL RD STE 1
Mailing Address - Street 2:
Mailing Address - City:SINKING SPRING
Mailing Address - State:PA
Mailing Address - Zip Code:19608-1678
Mailing Address - Country:US
Mailing Address - Phone:610-717-5722
Mailing Address - Fax:610-750-7167
Practice Address - Street 1:2921 WINDMILL RD STE 1
Practice Address - Street 2:
Practice Address - City:SINKING SPRING
Practice Address - State:PA
Practice Address - Zip Code:19608-1678
Practice Address - Country:US
Practice Address - Phone:610-717-5722
Practice Address - Fax:610-750-7167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-08
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA219940261QA0600X
PA233210320900000X
PA229500320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100004147OtherMPI