SPECTRUM HABILITATION SERVICE INC. (NPI# 1760714299) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760714299 |
| Entity Type | Organization |
| Organization Name | SPECTRUM HABILITATION SERVICE INC. |
| Other Organization Name | SPECTRUM HABILITATION SERVICES #A, #B, #C, #D, #E |
| Practice Address |
310 Magnolia Walk Lane College Park GA 30349 |
| Mailing Address |
310 Magnolia Walk Ln College Park GA 30349-4072 |
| Practice Telephone | 4042762222 |
| Practice Fax Number | 4046914354 |
| Mailing Fax Number | 4046914354 |
| Enumeration Date | 2010-02-09 |
| Last Update Date | 2010-02-09 |
| Authorized Official Name | MRS. LYDIA JACKSON-SMITH (DIRECTOR) |
| Authorized Official Telephone | 4042762222 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0400X |
Clinic/Center Specialization: Rehabilitation |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 252549320B | 05 |
| Other Name | Type Code |
|---|---|
| Spectrum Habilitation Services #A, #B, #C, #D, #E | Doing Business As Name - Organization |
| Street Address |
310 MAGNOLIA WALK LANE |
| City | COLLEGE PARK |
| State | GA |
| Zip Code | 30349 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376185686 | Kmb Diagnostics | Durable Medical Equipment & Medical Supplies | 941 Flat Shoals Rd, Atlanta, GA 30349 | 2019-10-09 |
| 1114575859 | Justin Vassell | Registered Nurse | 1903 Phoenix Boulevard, Suite 200, College Park, GA 30349 | 2019-08-27 |
| 1841856663 | Kennyetta Danielle Watkins | Counselor | 1431 Riverwalk Ln, Apt. F, College Park, GA 30349 | 2019-05-16 |
| 1275002636 | Patriot Healthcare of Georgia, LLC | Family Medicine | 1587 Phoenix Boulevard, Suite 6, College Park, GA 30349 | 2018-11-15 |
| 1669971875 | Ee Consulting Solution | Case Management | 6320 Topaz Tral, Arlanta, GA 30349 | 2018-02-03 |
| 1629595640 | Shayla Bouie | Contractor | 5420 Riverdale Rd Apt D17, Atlanta, GA 30349 | 2017-08-30 |
| 1114475563 | Jasmine V Mccully | Social Worker | 5864 Summergien Lane, College Park, GA 30349 | 2016-09-14 |
| 1639537681 | Shelia Thornton | Counselor | 5856 Seabright Lane, Atlanta, GA 30349 | 2016-02-05 |
| 1346610177 | Joanne Resilard | Nurse Practitioner | 2931 Herron Ln Sw, Atlanta, GA 30349 | 2015-10-06 |
| 1063805091 | Southwest Atlanta Medical & Rehabilitation Clinic LLC | Family Medicine | 495 85 Circle, Suite 100, Atlanta, GA 30349 | 2015-03-16 |
| Find all providers in zip 30349 | ||||
| Taxonomy Code | 261QR0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639254550 | Physiotherapy Associates Inc | Clinic/Center | 1669 Phoenix Pkwy, Suite 102, College Park, GA 30349-5462 | 2006-10-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336763150 | Esop Rehabilitation, LLC | Clinic/Center | 1699 Highway 124 N Ste 100, Snellville, GA 30078-7921 | 2020-06-08 |
| 1912566811 | Tattnall Hospital Company, LLC | Clinic/Center | 10200 Ford Ave Ste 105, Richmond Hill, GA 31324-8824 | 2019-06-13 |
| 1790289544 | Effingham Rehab Services, LLC | Clinic/Center | 105 E Bacon St, Pembroke, GA 31321 | 2018-03-19 |
| 1457874976 | Effingham Rehab Services, Inc | Clinic/Center | 111 Jazie Dr Ste E, Savannah, GA 31410-1908 | 2017-07-18 |
| 1770006272 | Effingham Rehab Services, Inc | Clinic/Center | 22 W Oglethorpe Ave, Savannah, GA 31401-3702 | 2017-07-18 |
| 1588187090 | Effingham Rehab Services, Inc | Clinic/Center | 475 S Main St Ste B, Hinesville, GA 31313-1365 | 2017-07-18 |
| 1447773908 | Effingham Rehab Services, Inc | Clinic/Center | 2709 Us Highway 17 Ste 2a, Richmond Hill, GA 31324-3795 | 2017-07-17 |
| 1437689288 | Dr. Peggy Marbach Vestibular Rehab Specialist, LLC | Clinic/Center | 6849 Peachtree Dunwoody Road, Building B-4, Suite #100, Sandy Springs, GA 30328-6776 | 2017-06-14 |
| 1699207274 | Vestibular Linc LLC | Clinic/Center | 921 Harmony Rd Ste 2, Eatonton, GA 31024-9618 | 2017-04-01 |
| 1346784113 | Genesis Eldercare Rehabilitation Services LLC | Clinic/Center | 1600 Ballewtown Rd, C/o Blue Ridge Assisted Living, Blue Ridge, GA 30513-5337 | 2016-12-13 |
| Find all providers with the same taxonomy | ||||
| City | COLLEGE PARK |
| Zip Code | 30349 |
Please comment or provide details below to improve the information on SPECTRUM HABILITATION SERVICE INC..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.