NPIMap

Organization Active NPI

Spectrum Rehab Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Denham Springs, LA
National Provider Identifier
1356493530
Registry record updated Jul 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
SPECTRUM REHAB SERVICES, INC.
Practice address
30826 Linder Rd
Denham Springs, LA 70726-8507
Phone
(225) 665-7878
Fax
(225) 665-7856
NPI assigned
Jan 17, 2007
Last updated
Jul 24, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2023

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

Authorized official

Name
Mr. Kyle Jacob
Title
Coo
Phone
(318) 746-0420

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Community/Behavioral Health Agency 251S00000X 1548839 LA

Addresses

Primary practice location

30826 Linder Rd
Denham Springs, LA 70726-8507

Mailing address

30826 Linder Rd
Denham Springs, LA 70726-8507
Phone (225) 665-7878

Other identifiers 2

IdentifierTypeStateIssuer
1989151MedicaidLA
1548839MedicaidLA

National Provider Directory

National Provider Directory

Locations

30826 Linder Rd
Denham Springs, LA 70726
Phone (225) 665-7878

Practitioners & affiliated clinicians

Practitioners 104

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 104

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690156800000",
    "number": "1356493530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30826 LINDER RD",
            "city": "DENHAM SPRINGS",
            "state": "LA",
            "postal_code": "707268507",
            "telephone_number": "225-665-7878",
            "fax_number": "225-665-7856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30826 LINDER RD",
            "city": "DENHAM SPRINGS",
            "state": "LA",
            "postal_code": "707268507",
            "telephone_number": "225-665-7878",
            "fax_number": "225-665-7856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM REHAB SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A",
        "authorized_official_last_name": "JACOB",
        "authorized_official_first_name": "KYLE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "318-746-0420",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "LA",
            "license": "1548839",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1989151",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1548839",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denham Springs, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2023; 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.