Provider Demographics
NPI:1316303688
Name:FULL SPECTRUM HEALTH SERVICES LLC
Entity type:Organization
Organization Name:FULL SPECTRUM HEALTH SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:BATENGA
Authorized Official - Middle Name:NASSOLO
Authorized Official - Last Name:OBUSEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-210-9779
Mailing Address - Street 1:1320 MENDOTA ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53714-1096
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1320 MENDOTA ST
Practice Address - Street 2:SUITE 110
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53714-1096
Practice Address - Country:US
Practice Address - Phone:608-237-3525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FULL SPECTRUM HEALTH SERVICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-01-02
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care