Provider Demographics
NPI:1457742553
Name:SPECTRUM ACADEMY
Entity Type:Organization
Organization Name:SPECTRUM ACADEMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:H
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-936-0318
Mailing Address - Street 1:575 CUTLER DR
Mailing Address - Street 2:
Mailing Address - City:NORTH SALT LAKE
Mailing Address - State:UT
Mailing Address - Zip Code:84054-2953
Mailing Address - Country:US
Mailing Address - Phone:801-936-0318
Mailing Address - Fax:801-936-0209
Practice Address - Street 1:575 CUTLER DR
Practice Address - Street 2:
Practice Address - City:NORTH SALT LAKE
Practice Address - State:UT
Practice Address - Zip Code:84054-2953
Practice Address - Country:US
Practice Address - Phone:801-936-0318
Practice Address - Fax:801-936-0209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-10
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)