SPECTRUM OF HOPE, LLC; NPI #1669983409

Contact Information

SPECTRUM OF HOPE, LLC

4908 S SHERIDAN RD
TULSA, OK 74145-5712

Phone: 918-984-9153
Fax:
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Multi-Specialty	261QM1300X	70	Clinic or Group Practice
Behavior Analyst	103K00000X
Clinical Child & Adolescent	103TC2200X	62	Psychologist, Clinical
Community Health Worker	172V00000X
Dietitian, Registered	133V00000X	71	Registered Dietitian or Nutrition Professional
Intellectual & Developmental Disabilities	103TM1800X	62	Psychologist, Clinical
Mental Health	101YM0800X
Mental Health	225XM0800X	67	Occupational Therapist in Private Practice
Nutrition, Pediatric	133VN1004X	71	Registered Dietitian or Nutrition Professional
Occupational Therapist	225X00000X	67	Occupational Therapist in Private Practice
Occupational Therapy Assistant	224Z00000X
Physical Therapist	225100000X	65	Physical Therapist in Private Practice
Speech-Language Pathologist	235Z00000X	15	Speech Language Pathologist

Indicates primary specialty

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NPI Profile & details for SPECTRUM OF HOPE, LLC

NPI Number 1669983409

LBN Legal business name SPECTRUM OF HOPE, LLC

Authorized official JONATHAN WEDEL - (COO)

Entity Organization

Organization subpart ¹ No

Enumeration date 10/19/2017

Last updated 01/10/2021 - About 5 years ago

Identifiers

Medicaid

200745940

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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SPECTRUM OF HOPE, LLC

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NPI Profile & details for SPECTRUM OF HOPE, LLC

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