Organization
SPECTRUM 360 A NEW JERSEY NONPROFIT CORPORATION
Active
Other names
Spectrum360
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE ETTINGER (EXECUTIVE DIRECTOR)
(973) 509-3050
Entity
Organization
Contact information
Practice address
60 S JEFFERSON RD, SUITE 7, WHIPPANY, NJ 07981-1067
(973) 509-3050
(973) 509-0185
Mailing address
414 EAGLE ROCK AVE, SUITE 200 B, WEST ORANGE, NJ 07052-4229
(973) 509-3050
(973) 509-0185
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
221500528A
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0496138
—
NJ
Enumeration date
10/21/2016
Last updated
10/21/2016
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