Healthcare Provider Details

I. General information

NPI: 1346915360
Provider Name (Legal Business Name): THE LITTLE LEARNERS SPECTRUM CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2021
Last Update Date: 08/11/2021
Certification Date: 08/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

840 PROGRESS DR
FARMINGTON MO
63640-9157
US

IV. Provider business mailing address

1723 MADISON 250
FREDERICKTOWN MO
63645-8452
US

V. Phone/Fax

Practice location:
  • Phone: 573-915-5006
  • Fax:
Mailing address:
  • Phone: 573-330-1038
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY DAWN SMITH
Title or Position: OWNER
Credential:
Phone: 573-330-1038