Organization
SPECRTUM LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FITZGERALD CONRAD COFIE (PARTNER)
(515) 771-2340
Entity
Organization
Contact information
Practice address
903 SE RENE ST, ANKENY, IA 50021-3982
(515) 771-2340
Mailing address
903 SE RENE ST, ANKENY, IA 50021-3982
(515) 771-2340
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/28/2021
Last updated
02/28/2021
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