Pro-Spectrum Autism Support Services

Primary specialty

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

Legal business name

PRO-SPECTRUM AUTISM SUPPORT SERVICES

Practice address

142 Brookfield Dr
Jackson, NJ 08527-3857

Phone

(347) 446-4023

NPI assigned

Apr 14, 2021

Organization subpart

No

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

Authorized official

Name

Michele Clay

Title

Ceo

Phone

(347) 446-4023

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1618358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618358400000",
    "number": "1942881727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 BROOKFIELD DR",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085273857",
            "telephone_number": "347-446-4023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 BROOKFIELD DR",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085273857",
            "telephone_number": "347-446-4023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO-SPECTRUM AUTISM SUPPORT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-14",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A",
        "authorized_official_last_name": "CLAY",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "347-446-4023"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Jackson, NJ
• Providers in Jackson, NJ by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 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.