Spectrum Support Center, LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

SPECTRUM SUPPORT CENTER, LLC

Practice address

2120 Mistletoe Blvd
Suite 3
Fort Worth, TX 76110-1174

Phone

(832) 385-6095

NPI assigned

Jun 15, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Phillip Keese

Title

Chief Operating Officer

Phone

(832) 385-6095

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1465948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465948800000",
    "number": "1215387808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 MISTLETOE BLVD",
            "address_2": "SUITE 3",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761101175",
            "telephone_number": "832-385-6095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 MISTLETOE BLVD",
            "address_2": "SUITE 3",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761101174",
            "telephone_number": "832-385-6095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM SUPPORT CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-15",
        "last_updated": "2016-06-15",
        "status": "A",
        "authorized_official_last_name": "KEESE",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "832-385-6095",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Fort Worth, TX
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• Behavior Analyst in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2016; 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.