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Organization

SPECTRUM PROFESSIONAL SERVICES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LACEY BRANDON LMSW (DIRECTOR)
(203) 695-4917
Entity
Organization

Contact information

Practice address
77-79 BISHOP ST, WATERBURY, CT 06704-3306
(203) 756-7987
Mailing address
77-79 BISHOP STREET, WATERBURY, CT 06704-1443

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
1113
CT
251S00000X
Community/Behavioral Health Agency
Primary
2384
CT

Other

Enumeration date
05/02/2016
Last updated
08/31/2016
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