| Spectrum Social And Recreation Services, Llc | |
|
1509 W North Loop Blvd Austin TX 78756-2004 | |
| (512) 524-5482 | |
| (512) 524-1177 |
| Full Name | Spectrum Social And Recreation Services, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1509 W North Loop Blvd, Austin, Texas |
| Authorized Official Name and Position | Shanna Kemp (PARTNER / BUSINESS MANAGER) |
| Authorized Official Contact | 5125245482 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Spectrum Social And Recreation Services, Llc 1509 W North Loop Blvd Austin TX 78756-2004 Ph: (512) 524-5482 | Spectrum Social And Recreation Services, Llc 1509 W North Loop Blvd Austin TX 78756-2004 Ph: (512) 524-5482 |
| NPI Number | 1770877342 |
|---|---|
| Provider Enumeration Date | 06/01/2011 |
| Last Update Date | 06/01/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770877342 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 252Y00000X | Early Intervention Provider Agency | (* (Not Available)) | Secondary |
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