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SPECTRUM BEHAVIORAL HEALTH LLC NPI 1053718890


NPI Information

NPI: 1053718890
Provider Name: SPECTRUM BEHAVIORAL HEALTH LLC
Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization
Address:
1496 BELLEVUE ST
SUITE 101
GREEN BAY, WI
ZIP 54311
Phone: (920) 784-2644
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SPECTRUM BEHAVIORAL HEALTH LLC is a community behavioral health in Green Bay, WI. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. SPECTRUM BEHAVIORAL HEALTH LLC NPI is 1053718890. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1496 BELLEVUE ST
SUITE 101
GREEN BAY, WI
ZIP 54311-205
Phone: (920) 784-2644

The provider's authorized official is Linda A Carmody .
The authorized official title is Clinic Director and has the following contact phone number (920) 784-2646.

The enumeration date for this NPI number is 11/21/2014 and was last updated on 6/17/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363LP0808XNurse PractitionerPsychiatric/Mental Health1826-33WISCONSINNo
2251S00000XCommunity/Behavioral Health4151-125WISCONSINYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1100043151MEDICAIDWISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.