Healthcare Provider Details

I. General information

NPI: 1821827841
Provider Name (Legal Business Name): SPECTRUM SUPPORT SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2024
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9800 SUN CHASER TRL SW
ALBUQUERQUE NM
87121-4272
US

IV. Provider business mailing address

9800 SUN CHASER TRL SW
ALBUQUERQUE NM
87121-4272
US

V. Phone/Fax

Practice location:
  • Phone: 505-639-1542
  • Fax:
Mailing address:
  • Phone: 505-639-1542
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: ESTANIA JEAN CHARLES
Title or Position: CEO
Credential: BCBA
Phone: 505-639-1542