Spectrum Therapy Center LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

SPECTRUM THERAPY CENTER LLC

Practice address

4124 Quebec Ave N Ste 303
New Hope, MN 55427-1241

Phone

(612) 607-3963

NPI assigned

Apr 26, 2023

Last updated

Jul 6, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mohamed A MohamedNPI 1265279368

Title

Owner

Phone

(612) 987-4002

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mohamed A Mohamed

  • Behavior Technician
  • Burnsville, MN
  • NPI 1265279368
  NPD Authorized official

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

{
    "created_epoch": "1682467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720224000000",
    "number": "1033807276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4124 QUEBEC AVE N STE 303",
            "city": "NEW HOPE",
            "state": "MN",
            "postal_code": "554271241",
            "telephone_number": "612-607-3963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4124 QUEBEC AVE N STE 303",
            "city": "NEW HOPE",
            "state": "MN",
            "postal_code": "554271241",
            "telephone_number": "612-607-3963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM THERAPY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-26",
        "last_updated": "2024-07-06",
        "certification_date": "2024-07-06",
        "status": "A",
        "authorized_official_last_name": "MOHAMED",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-987-4002"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 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.