Spectrum Village, Pllc

LBN: Spectrum Village, Pllc
Spectrum Village, Pllc is an health care organization with primary practice located at 4150 W Peoria Ave Ste. 133, Phoenix AZ 85029-3900. The organization recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Behavioral Analyst, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is the primary health care specialty. Spectrum Village, Pllc can be contacted via phone (602) 910-0526, or through Lichte-Brill, Lori Kim via phone (602) 910-0526.

Contact Information

Primary practice address
4150 W Peoria Ave Ste. 133 Phoenix AZ 85029-3900
Phone: (602) 910-0526
Fax: (602) 346-0117
Website:
Map and Directions
Authorized official contact:
Name: Lichte-Brill, Lori Kim PSY.D.
Phone: (602) 910-0526

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X 127 Arizona
Behavioral Health & Social Service Providers / Clinical 103TC0700X 4484 Arizona

Profile Details

NPI number 1841686078
LBN Legal business name Spectrum Village, Pllc
DBA Doing business as
Authorized official Lichte-Brill, Lori Kim PSY.D.
Entity Organization
Organization subpart 1 No
Enumeration date Apr 14th, 2015
Last updated Apr 14th, 2015 - about 9 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841686078 NPPES
Arizona Other 462224 AHCCCS

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