Organization
SPECTRUM HEIGHTS LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. OLUMIDE EDEMODU M.S. BCBA (OWNER/BEHAVIOR ANALYST)
(646) 251-0799
Entity
Organization
Contact information
Practice address
436 COLLIER RD NW, ATLANTA, GA 30309-1202
(646) 251-0799
Mailing address
436 COLLIER RD NW, ATLANTA, GA 30309-1202
(646) 251-0799
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
16097319
GA
251S00000X
Community/Behavioral Health Agency
Primary
16097319
GA
Other
Enumeration date
03/23/2017
Last updated
03/23/2017
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