Provider Demographics
NPI:1235957945
Name:ABOVE THE SPECTRUM, INC
Entity type:Organization
Organization Name:ABOVE THE SPECTRUM, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, REGISTERED NURSE
Authorized Official - Prefix:
Authorized Official - First Name:LYTISSUE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE
Authorized Official - Phone:334-440-9975
Mailing Address - Street 1:1392 DAYSPRING TRCE
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30045-5475
Mailing Address - Country:US
Mailing Address - Phone:334-440-9975
Mailing Address - Fax:
Practice Address - Street 1:1392 DAYSPRING TRCE
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30045-5475
Practice Address - Country:US
Practice Address - Phone:334-440-9975
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-01
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Single Specialty