Organization Active NPI

Spectrum Industries

  • Developmentally Disabled Services Day Training Agency
  • Decorah, IA
National Provider Identifier
1003901778
Registry record updated Dec 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Legal business name
SPECTRUM INDUSTRIES
Doing business as
The Spectrum Network
Practice address
607 Washington Street, Suite 1
Decorah, IA 52101-2240
Phone
(563) 382-8401
Fax
(563) 382-8403
NPI assigned
Oct 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Christopher Michael Miculinich
Title
Executive Director
Phone
(563) 382-8401

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X Primary
Home Infusion Agency 251F00000X

Addresses

Primary practice location

607 Washington Street, Suite 1
Decorah, IA 52101-2240

Mailing address

607 Washington Street, Suite 1
Decorah, IA 52101-2240
Phone (563) 382-8401

Other identifiers 4

IdentifierTypeStateIssuer
02-35754MedicaidIA
12-35754MedicaidIA
0166983MedicaidIA
2235754MedicaidIA

Other names 1

  • The Spectrum Network Doing business as

National Provider Directory

National Provider Directory

Locations

607 Washington St
Ste 1
Decorah, IA 52101
Phone (563) 382-8401

607 Washington St
Decorah, IA 52101

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734652800000",
    "number": "1003901778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 WASHINGTON STREET, SUITE 1",
            "city": "DECORAH",
            "state": "IA",
            "postal_code": "521012240",
            "telephone_number": "563-382-8401",
            "fax_number": "563-382-8403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 WASHINGTON STREET, SUITE 1",
            "city": "DECORAH",
            "state": "IA",
            "postal_code": "521012240",
            "telephone_number": "563-382-8401",
            "fax_number": "563-382-8403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM INDUSTRIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2024-12-20",
        "status": "A",
        "authorized_official_last_name": "MICULINICH",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "563-382-8401"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02-35754",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12-35754",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0166983",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2235754",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Spectrum Network",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Decorah, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.