Specrtum Living LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

SPECRTUM LIVING LLC

Practice address

903 SE Rene St
Ankeny, IA 50021-3982

Phone

(515) 771-2340

NPI assigned

Feb 28, 2021

Last updated

Feb 28, 2021By 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

Mr. Fitzgerald Conrad CofieNPI 1073336970

Title

Partner

Phone

(515) 771-2340

Specialties & licenses 1

Addresses

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.

• Fitzgerald Conrad Cofie

  • Community/Behavioral Health Agency
  • Des Moines, IA
  • NPI 1073336970
  NPD Authorized official

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

{
    "created_epoch": "1614470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614470400000",
    "number": "1174117386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 SE RENE ST",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500213982",
            "telephone_number": "515-771-2340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 SE RENE ST",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500213982",
            "telephone_number": "515-771-2340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECRTUM LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-28",
        "last_updated": "2021-02-28",
        "certification_date": "2021-02-28",
        "status": "A",
        "authorized_official_last_name": "COFIE",
        "authorized_official_first_name": "FITZGERALD",
        "authorized_official_middle_name": "CONRAD",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "515-771-2340",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Snyder, RPH
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• Eferonia Soliman
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• John David Sperry
• Alayna Irene Spiece
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• Ben Reed Sponsler, LMT, MMP

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Ankeny, IA
• Providers in Ankeny, IA by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2021; 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.