NPIMap

Organization Active NPI

Spectrum Community Services

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Westland, MI
National Provider Identifier
1164577391
Registry record updated Jun 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
AS820092071 Issued in MI
Legal business name
SPECTRUM COMMUNITY SERVICES
Practice address
28303 Joy Rd
Westland, MI 48185
Phone
(616) 241-6258
Fax
(616) 241-6470
NPI assigned
Jan 25, 2007
Last updated
Jun 18, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
SPECTRUM HUMAN SERVICES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 18, 2024

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

Authorized official

Name
Mrs. Sharon Kay Blain
Title
Executive Director
Phone
(616) 241-6258

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X AS820092071 MI Primary

Addresses

Primary practice location

28303 Joy Rd
Westland, MI 48185

Mailing address

28303 Joy Rd
Westland, MI 48185
Phone (616) 241-6258

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080811000024 MI Part B Supplier - Clinic/Group Practice 4486728383 Receives reassigned benefits from 1 practitioner
Practice locations: Grand Rapids, MI

National Provider Directory

National Provider Directory
Tax ID family
Spectrum Community Services2 organizations share this tax ID, including this one
Part of
Spectrum Human Servicesinc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3485 Rogue River Rd NE
Belmont, MI 49306
Phone (616) 447-9380

1111 40th St SE
Wyoming, MI 49508
Phone (616) 516-7131

Practitioners & affiliated clinicians

Practitioners 76

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.

View all 76

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718668800000",
    "number": "1164577391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28303 JOY RD",
            "city": "WESTLAND",
            "state": "MI",
            "postal_code": "48185",
            "telephone_number": "616-241-6258",
            "fax_number": "616-241-6470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28303 JOY RD",
            "city": "WESTLAND",
            "state": "MI",
            "postal_code": "48185",
            "telephone_number": "616-241-6258",
            "fax_number": "616-241-6470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM COMMUNITY SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPECTRUM HUMAN SERVICES, INC.",
        "enumeration_date": "2007-01-25",
        "last_updated": "2024-06-18",
        "status": "A",
        "authorized_official_last_name": "BLAIN",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "616-241-6258",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "MI",
            "license": "AS820092071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.