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Organization
SPECTRUM HABILITATION SERVICE INC.
Active
Organization
SPECTRUM HABILITATION SERVICE INC.
Active
Other names
Spectrum Habilitation Services #A, #B, #C, #D, #E
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LYDIA JACKSON-SMITH (DIRECTOR)
(404) 276-2222
Entity
Organization
Contact information
Practice address
310 MAGNOLIA WALK LANE, COLLEGE PARK, GA 30349
(404) 276-2222
(404) 691-4354
Mailing address
310 MAGNOLIA WALK LN, COLLEGE PARK, GA 30349-4072
(404) 691-4354
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
252549320B
—
GA
Enumeration date
02/09/2010
Last updated
02/09/2010
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