Provider Demographics
NPI: | 1902213671 |
---|---|
Name: | SPAHAUTE COMPANY |
Entity type: | Organization |
Organization Name: | SPAHAUTE COMPANY |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | C.E.O. |
Authorized Official - Prefix: | MRS |
Authorized Official - First Name: | ANGELA |
Authorized Official - Middle Name: | MARIE |
Authorized Official - Last Name: | BOYD |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | RN |
Authorized Official - Phone: | 812-242-7000 |
Mailing Address - Street 1: | 680 E SPRINGHILL DR |
Mailing Address - Street 2: | |
Mailing Address - City: | TERRE HAUTE |
Mailing Address - State: | IN |
Mailing Address - Zip Code: | 47802-6804 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 812-242-7000 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 680 E SPRINGHILL DR |
Practice Address - Street 2: | |
Practice Address - City: | TERRE HAUTE |
Practice Address - State: | IN |
Practice Address - Zip Code: | 47802-6804 |
Practice Address - Country: | US |
Practice Address - Phone: | 812-242-7000 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2014-07-15 |
Last Update Date: | 2022-07-21 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
IN | 261QP3300X, 261QR0400X, 261QR0404X, 261QR1100X, 261QX0203X, 261Q00000X, 261QC1500X, 261QC1800X, 261QE0800X, 261QH0700X, 261QM0801X, 261QM0850X, 261QM0855X, 261QM1300X, 261QH0100X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QH0100X | Ambulatory Health Care Facilities | Clinic/Center | Health Service |
No | 261QP3300X | Ambulatory Health Care Facilities | Clinic/Center | Pain |
No | 261QR0400X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation |
No | 261QR0404X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Cardiac Facilities |
No | 261QR1100X | Ambulatory Health Care Facilities | Clinic/Center | Research |
No | 261QX0203X | Ambulatory Health Care Facilities | Clinic/Center | Oncology, Radiation |
No | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center | |
No | 261QC1500X | Ambulatory Health Care Facilities | Clinic/Center | Community Health |
No | 261QC1800X | Ambulatory Health Care Facilities | Clinic/Center | Corporate Health |
No | 261QE0800X | Ambulatory Health Care Facilities | Clinic/Center | Endoscopy |
No | 261QH0700X | Ambulatory Health Care Facilities | Clinic/Center | Hearing and Speech |
No | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |
No | 261QM0850X | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health |
No | 261QM0855X | Ambulatory Health Care Facilities | Clinic/Center | Adolescent and Children Mental Health |
No | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty |