Provider Demographics
NPI:1396288072
Name:SPECTRUM RECOVERY INC
Entity type:Organization
Organization Name:SPECTRUM RECOVERY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MS
Authorized Official - First Name:AJA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-708-5063
Mailing Address - Street 1:PO BOX 2926
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27331-2926
Mailing Address - Country:US
Mailing Address - Phone:919-708-5063
Mailing Address - Fax:844-270-8354
Practice Address - Street 1:111 DENNIS DR STE 115
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-6461
Practice Address - Country:US
Practice Address - Phone:919-708-5063
Practice Address - Fax:919-774-3155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-29
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health