Provider Demographics
NPI:1528185519
Name:SPECTRUM PARTNERS L.L.C.
Entity type:Organization
Organization Name:SPECTRUM PARTNERS L.L.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:S
Authorized Official - Last Name:HARBERT
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:573-588-4115
Mailing Address - Street 1:218 E SHELBINA AVE
Mailing Address - Street 2:
Mailing Address - City:SHELBINA
Mailing Address - State:MO
Mailing Address - Zip Code:63468-4328
Mailing Address - Country:US
Mailing Address - Phone:573-588-4115
Mailing Address - Fax:573-588-2383
Practice Address - Street 1:RR 2 BOX 490
Practice Address - Street 2:
Practice Address - City:ADRIAN
Practice Address - State:MO
Practice Address - Zip Code:64720-9599
Practice Address - Country:US
Practice Address - Phone:816-297-8832
Practice Address - Fax:816-297-8832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO032070310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility