Provider Demographics
NPI:1871371237
Name:SPECTRUM BEHAVIOR THERAPY, LLC
Entity type:Organization
Organization Name:SPECTRUM BEHAVIOR THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:
Authorized Official - First Name:ANA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:RODRIGUEZ JO
Authorized Official - Suffix:
Authorized Official - Credentials:RBT-23-295645
Authorized Official - Phone:786-856-8370
Mailing Address - Street 1:3429 SARANAC AVE
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-4930
Mailing Address - Country:US
Mailing Address - Phone:786-856-8370
Mailing Address - Fax:
Practice Address - Street 1:3429 SARANAC AVE
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-4930
Practice Address - Country:US
Practice Address - Phone:786-856-8370
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty