Healthcare Provider Details

I. General information

NPI: 1225647951
Provider Name (Legal Business Name): SPECTRUM WARRIORS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2020
Last Update Date: 07/28/2020
Certification Date: 07/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

263 RILEY RD
NEW WINDSOR NY
12553-7272
US

IV. Provider business mailing address

200 W 143RD ST APT 18E
NEW YORK NY
10030-1530
US

V. Phone/Fax

Practice location:
  • Phone: 917-539-2026
  • Fax:
Mailing address:
  • Phone: 917-539-2026
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385HR2050X
TaxonomyRespite Care Camp
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: MS. MICHELE SANCHEZ-STIERHEIM
Title or Position: FOUNDER
Credential: DIR FLOORTIME
Phone: 917-539-2026