Organization
SPECTRUM REHAB SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KYLE JACOB (COO)
(318) 746-0420
Entity
Organization
Contact information
Practice address
30826 LINDER RD, DENHAM SPRINGS, LA 70726-8507
(225) 665-7878
(225) 665-7856
Mailing address
30826 LINDER RD, DENHAM SPRINGS, LA 70726-8507
(225) 665-7878
(225) 665-7856
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
1548839
LA
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1548839
—
LA
05
—
1989151
—
LA
Enumeration date
01/17/2007
Last updated
07/24/2023
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