Provider Demographics
NPI:1720448459
Name:SPECTRUM BEHAVIORAL SERVICES, INC
Entity type:Organization
Organization Name:SPECTRUM BEHAVIORAL SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:B
Authorized Official - Last Name:BENSMIHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:561-491-2335
Mailing Address - Street 1:4700 NW 2ND AVENUE
Mailing Address - Street 2:SUITE 402
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-4160
Mailing Address - Country:US
Mailing Address - Phone:561-491-2335
Mailing Address - Fax:561-989-0698
Practice Address - Street 1:4700 NW 2ND AVENUE
Practice Address - Street 2:SUITE 402
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-4160
Practice Address - Country:US
Practice Address - Phone:561-491-2335
Practice Address - Fax:561-989-0698
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-23
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251C00000X
261QD1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities