Active NPI
Spectrum Industries
- Developmentally Disabled Services Day Training Agency
- Decorah, IA
National Provider Identifier
1003901778
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmentally Disabled Services Day Training Agency
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02-35754 | Medicaid | IA | |
| 12-35754 | Medicaid | IA | |
| 0166983 | Medicaid | IA | |
| 2235754 | Medicaid | IA |
Other names 1
- The Spectrum Network
National Provider Directory
National Provider DirectoryLocations
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.