SPECTRUM OF HOPE LLC NPI 1669983409

NPI Information

NPI: 1669983409
Provider Name: SPECTRUM OF HOPE, LLC

Doing Business As: SOARING ON HOPE PEDIATRIC THERAPY AND AUTISM CENTER

Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

Address:
4908 S SHERIDAN RD
TULSA, OK
ZIP 74145
Phone: (918) 984-9153
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SPECTRUM OF HOPE, LLC is a multi-specialty clinic center in Tulsa, OK. SPECTRUM OF HOPE, LLC NPI is 1669983409. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Soaring On Hope Pediatric Therapy And Autism Center.

The provider's business location address is:

4908 S SHERIDAN RD
TULSA, OK
ZIP 74145-712
Phone: (918) 984-9153

The provider's authorized official is Jonathan Ryan Wedel .
The authorized official title is Coo and has the following contact phone number (918) 984-9153.

The enumeration date for this NPI number is 10/19/2017 and was last updated on 1/10/2021.

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 Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	225X00000X	Occupational Therapist		No
2	235Z00000X	Speech-Language Pathologist		No
3	225XM0800X	Occupational Therapist	Mental Health	No
4	224Z00000X	Occupational Therapy Assistant		No
5	225100000X	Physical Therapist		No
6	101YM0800X	Counselor	Mental Health	No
7	103K00000X	Behavior Analyst		No
8	103TC2200X	Psychologist	Clinical Child & Adolescent	No
9	103TM1800X	Psychologist	Intellectual and Developmental Disabilities	No
10	133V00000X	Dietitian, Registered		No
11	133VN1004X	Dietitian, Registered	Nutrition, Pediatric	No
12	172V00000X	Community Health Worker		No
13	261QM1300X	Clinic/Center	Multi-Specialty	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	200745940	MEDICAID	OKLAHOMA

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: 4/28/2024

NPI Synchronization or Removal

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