Provider Demographics
NPI:1790515187
Name:SUNFLOWER SPECTRUM ACADEMY
Entity type:Organization
Organization Name:SUNFLOWER SPECTRUM ACADEMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHERIE
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:678-870-4580
Mailing Address - Street 1:19 VALLEY FORGE PL NW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318-1455
Mailing Address - Country:US
Mailing Address - Phone:678-558-6799
Mailing Address - Fax:
Practice Address - Street 1:19 VALLEY FORGE PL NW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30318-1455
Practice Address - Country:US
Practice Address - Phone:678-558-6799
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-01
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty