Everbright Spectrum Services LLC

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Legal business name

EVERBRIGHT SPECTRUM SERVICES LLC

Practice address

100 Fuller St S Ste 270
Shakopee, MN 55379-1348

Phone

(612) 961-2491

NPI assigned

Feb 11, 2025

Organization subpart

No

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

Authorized official

Name

Ali Kofiro

Title

Co-Owner

Phone

(612) 961-2491

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.

• Aden Mohamud Fithar

  • Mental Health Counselor
  • Shakopee, MN
  • NPI 1255207742
  NPD

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

{
    "created_epoch": "1739232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739232000000",
    "number": "1447065800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 FULLER ST S STE 270",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553791348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 FULLER ST S STE 270",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553791348",
            "telephone_number": "612-961-2491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERBRIGHT SPECTRUM SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-11",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A",
        "authorized_official_last_name": "KOFIRO",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "612-961-2491"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Developmental Disabilities Clinic/Center in Shakopee, MN
• Providers in Shakopee, MN by specialty
• Developmental Disabilities Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; 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.