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General NPI Number Information
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NPI Number | 1427432822
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Entity Type | Organization
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Legal Business Name | SPECTRUM WORKS, INC
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Dates
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Enumeration Date | 07/15/2015
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Last Update Date | 02/16/2016
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Provider Practice Location Address
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Address Line | 565 WINDSOR DR
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City | SECAUCUS
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State | NJ
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Zip | 07094-2716
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Country | US
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Telephone | 201-552-2055
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Fax |
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Provider Business Mailing Address
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Address Line | 565 WINDSOR DR
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City | SECAUCUS
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State | NJ
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Zip | 07094-2716
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Country | US
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Telephone | 201-552-2055
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | ANN MARIE SULLIVAN
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Credential |
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Telephone | 973-866-6887
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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