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Provider Demographic Information - SPECTRA SUPPORT SERVICES LLC

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PROVIDER DEMOGRAPHIC INFORMATION Supporting line for group header


Name:	SPECTRA SUPPORT SERVICES LLC
Address:	390 REED RD FL 1 BROOMALL, PA 19008-4008
Phone:	(484) 450-6476
E-mail:	molson@spectrapa.com
Web Site:	N/A

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PROVIDER CERTIFICATION INFORMATION Supporting line for group header

Click here to view Provider Certification Information

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PROVIDER'S PARENT/ REGIONAL OFFICE Supporting line for group header


Type:	Corporate Office
Name:	Spectra Support Services LLC
Address:	390 REED RD # FL1 BROOMALL, PA 19008-4008
Phone:	(484) 450-6476
Fax:	(484) 224-3398

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PROVIDER SERVICES AND RATES Supporting line for group header


County : Allegheny
\|Service Name / Level	\|Rate

Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day

County : Armstrong/Indiana
\|Service Name / Level	\|Rate

Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day

County : Beaver
\|Service Name / Level	\|Rate

Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day

County : Bedford/Somerset
\|Service Name / Level	\|Rate

Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day

County : Berks
\|Service Name / Level	\|Rate

Behavioral Supports-Level 1-Initial/Ongoing	$22.08 / 15 min.
Behavioral Supports-Level 1-Initial/Ongoing-ECS	$27.10 / 15 min.
CPS Community 1:1	$12.81 / 15 min.
CPS Community 1:1 ECS	$14.97 / 15 min.
CPS Community 1:1 Enhanced	$17.83 / 15 min.
CPS Community 1:2 or 1:3	$6.98 / 15 min.
CPS Community 1:2 or 1:3-ECS	$8.02 / 15 min.
CPS Community 2:1	$24.62 / 15 min.
CPS Community 2:1 ECS	$29.07 / 15 min.
CPS Community 2:1 Enhanced	$29.70 / 15 min.
CPS Community 2:1 Enhanced ECS	$35.43 / 15 min.
CPS Community 2:3	$10.43 / 15 min.
CPS Community 2:3 -ECS	$13.60 / 15 min.
CPS Facility 1:1	$12.40 / 15 min.
CPS Facility 1:1 Enhanced	$17.27 / 15 min.
CPS Facility 1:1 Enhcd LPN	$17.27 / 15 min.
CPS Facility 1:1 Enhcd RN	$17.27 / 15 min.
CPS Facility 1:1 Enhcd-ECS	$20.66 / 15 min.
CPS Facility 1:1-ECS	$14.50 / 15 min.
CPS Facility 1:11 to 1:15	$2.96 / 15 min.
CPS Facility 1:11 to 1:15-ECS	$3.27 / 15 min.
CPS Facility 1:2 to 1:3	$6.84 / 15 min.
CPS Facility 1:2 to 1:3-ECS	$7.90 / 15 min.
CPS Facility 1:4 to 1:6	$5.23 / 15 min.
CPS Facility 1:4 to 1:6-ECS	$6.01 / 15 min.
CPS Facility 1:7 to 1:10	$3.18 / 15 min.
CPS Facility 1:7 to 1:10-ECS	$3.61 / 15 min.
CPS Facility 2:1	$23.77 / 15 min.
CPS Facility 2:1 Enhcd	$28.65 / 15 min.
CPS Facility 2:1 Enhcd LPN	$28.65 / 15 min.
CPS Facility 2:1 Enhcd RN	$28.65 / 15 min.
CPS Facility 2:1 Enhcd-ECS	$34.12 / 15 min.
CPS Facility 2:1-ECS	$27.96 / 15 min.
CPS:Community OnCall/Remote Support	$1.64 / 15 min.
In-Home & Commnty Supprts (Lvl 2)	$10.28 / 15 min.
In-Home & Commnty Supprts (Lvl 3 Enh)	$23.74 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$19.83 / 15 min.
Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day
Respite-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.
Respite-Unlic-15-min(Lvl 4, 2:1) In-Home	$15.77 / 15 min.

County : Blair
\|Service Name / Level	\|Rate

Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day

County : Bradford/Sullivan
\|Service Name / Level	\|Rate

Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day

County : Bucks
\|Service Name / Level	\|Rate

Behavioral Supports-Level 1-Initial/Ongoing	$22.08 / 15 min.
Behavioral Supports-Level 1-Initial/Ongoing-ECS	$27.10 / 15 min.
Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day

County : Butler
\|Service Name / Level	\|Rate

Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day

County : Cambria
\|Service Name / Level	\|Rate

Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day

County : Cameron/Elk
\|Service Name / Level	\|Rate

Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day

County : Carbon/Monroe/Pike
\|Service Name / Level	\|Rate

Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day

County : Centre
\|Service Name / Level	\|Rate

Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day

County : Chester
\|Service Name / Level	\|Rate

Behavioral Supports-Level 1-Initial/Ongoing	$22.08 / 15 min.
Behavioral Supports-Level 1-Initial/Ongoing-ECS	$27.10 / 15 min.
CPS Community 1:1	$12.81 / 15 min.
CPS Community 1:1 ECS	$14.97 / 15 min.
CPS Community 1:1 Enhanced	$17.83 / 15 min.
CPS Community 1:1 Enhanced ECS	$21.38 / 15 min.
CPS Community 1:2 or 1:3	$6.98 / 15 min.
CPS Community 1:2 or 1:3-ECS	$8.02 / 15 min.
CPS Community 2:1	$24.62 / 15 min.
CPS Community 2:1 ECS	$29.07 / 15 min.
CPS Community 2:1 Enhanced	$29.70 / 15 min.
CPS Community 2:1 Enhanced ECS	$35.43 / 15 min.
CPS Community 2:3	$10.43 / 15 min.
CPS Community 2:3 -ECS	$13.60 / 15 min.
CPS Facility 1:1	$12.40 / 15 min.
CPS Facility 1:1 Enhanced	$17.27 / 15 min.
CPS Facility 1:1 Enhcd LPN	$17.27 / 15 min.
CPS Facility 1:1 Enhcd RN	$17.27 / 15 min.
CPS Facility 1:1 Enhcd-ECS	$20.66 / 15 min.
CPS Facility 1:1-ECS	$14.50 / 15 min.
CPS Facility 1:11 to 1:15	$2.96 / 15 min.
CPS Facility 1:11 to 1:15-ECS	$3.27 / 15 min.
CPS Facility 1:2 to 1:3	$6.84 / 15 min.
CPS Facility 1:2 to 1:3-ECS	$7.90 / 15 min.
CPS Facility 1:4 to 1:6	$5.23 / 15 min.
CPS Facility 1:4 to 1:6-ECS	$6.01 / 15 min.
CPS Facility 1:7 to 1:10	$3.18 / 15 min.
CPS Facility 1:7 to 1:10-ECS	$3.61 / 15 min.
CPS Facility 2:1	$23.77 / 15 min.
CPS Facility 2:1 Enhcd	$28.65 / 15 min.
CPS Facility 2:1 Enhcd LPN	$28.65 / 15 min.
CPS Facility 2:1 Enhcd RN	$28.65 / 15 min.
CPS Facility 2:1 Enhcd-ECS	$34.12 / 15 min.
CPS Facility 2:1-ECS	$27.96 / 15 min.
CPS:Community OnCall/Remote Support	$1.64 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh)	$14.18 / 15 min.
In-Home & Commnty Supprts (Lvl 2)	$10.28 / 15 min.
In-Home & Commnty Supprts (Lvl 3 Enh)	$23.74 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$19.83 / 15 min.
Music Therapy	$17.42 / 15 min.
Needs Exception Allowance (NEA)-Adult Res (6400)	$0.01 - $1,422.73 / 1 Day
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	$0.01 - $1,719.24 / 1 Day
Res Hab-1 Person-NG 4-Elig	$1,118.74 / 1 Day
Res Hab-1 Person-NG 4-Elig-w/Day Supports	$822.23 / 1 Day
Res Hab-2 Person-NG 4-Elig	$820.15 / 1 Day
Res Hab-2 Person-NG 4-Elig-w/Day Supports	$689.49 / 1 Day
Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day
Res Hab-Lic-2 Person-Inelig	$54.05 / 1 Day
Respite-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.
Respite-Unlic-15-min(Lvl 4, 2:1) In-Home	$15.77 / 15 min.
Respite-Unlic-Day (Level 3, 1:1) In-Home	$317.80 / 1 Day
Supplemental Habilitation 1:1 - 15 min	$5.77 / 15 min.
Supplemental Habilitation 2:1 - 15 min	$11.53 / 15 min.

County : Clarion
\|Service Name / Level	\|Rate

Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day

County : Clearfield/Jefferson
\|Service Name / Level	\|Rate

Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day

County : Columbia/Montour/Snyder/Union
\|Service Name / Level	\|Rate

Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day

County : Crawford
\|Service Name / Level	\|Rate

Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day

County : Cumberland/Perry
\|Service Name / Level	\|Rate

Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day

County : Dauphin
\|Service Name / Level	\|Rate

Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day

County : Delaware
\|Service Name / Level	\|Rate

Behavioral Supports-Level 1-Initial/Ongoing	$22.08 / 15 min.
Behavioral Supports-Level 1-Initial/Ongoing-ECS	$27.10 / 15 min.
CPS Community 1:1	$12.81 / 15 min.
CPS Community 1:1 ECS	$14.97 / 15 min.
CPS Community 1:1 Enhanced	$17.83 / 15 min.
CPS Community 1:1 Enhanced ECS	$21.38 / 15 min.
CPS Community 1:2 or 1:3	$6.98 / 15 min.
CPS Community 1:2 or 1:3-ECS	$8.02 / 15 min.
CPS Community 2:1	$24.62 / 15 min.
CPS Community 2:1 ECS	$29.07 / 15 min.
CPS Community 2:1 Enhanced	$29.70 / 15 min.
CPS Community 2:1 Enhanced ECS	$35.43 / 15 min.
CPS Community 2:3	$10.43 / 15 min.
CPS Community 2:3 -ECS	$13.60 / 15 min.
CPS Facility 1:1	$12.40 / 15 min.
CPS Facility 1:1 Enhanced	$17.27 / 15 min.
CPS Facility 1:1 Enhcd LPN	$17.27 / 15 min.
CPS Facility 1:1 Enhcd RN	$17.27 / 15 min.
CPS Facility 1:1 Enhcd-ECS	$20.66 / 15 min.
CPS Facility 1:1-ECS	$14.50 / 15 min.
CPS Facility 1:11 to 1:15	$2.96 / 15 min.
CPS Facility 1:11 to 1:15-ECS	$3.27 / 15 min.
CPS Facility 1:2 to 1:3	$6.84 / 15 min.
CPS Facility 1:2 to 1:3-ECS	$7.90 / 15 min.
CPS Facility 1:4 to 1:6	$5.23 / 15 min.
CPS Facility 1:4 to 1:6-ECS	$6.01 / 15 min.
CPS Facility 1:7 to 1:10	$3.18 / 15 min.
CPS Facility 1:7 to 1:10-ECS	$3.61 / 15 min.
CPS Facility 2:1	$23.77 / 15 min.
CPS Facility 2:1 Enhcd	$28.65 / 15 min.
CPS Facility 2:1 Enhcd LPN	$28.65 / 15 min.
CPS Facility 2:1 Enhcd RN	$28.65 / 15 min.
CPS Facility 2:1 Enhcd-ECS	$34.12 / 15 min.
CPS Facility 2:1-ECS	$27.96 / 15 min.
CPS:Community OnCall/Remote Support	$1.64 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh)	$14.18 / 15 min.
In-Home & Commnty Supprts (Lvl 2)	$10.28 / 15 min.
In-Home & Commnty Supprts (Lvl 3 Enh)	$23.74 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$19.83 / 15 min.
Music Therapy	$17.42 / 15 min.
Needs Exception Allowance (NEA)-Adult Res (6400)	$0.01 - $1,125.86 / 1 Day
Needs Excptn Allowance (NEA)-Adult Res (6400)-521	$0.01 - $1,387.37 / 1 Day
Res Hab-1 Person-NG 4-Elig	$1,118.74 / 1 Day
Res Hab-1 Person-NG 4-Elig-w/Day Supports	$822.23 / 1 Day
Res Hab-2 Person-NG 4-Elig	$820.15 / 1 Day
Res Hab-2 Person-NG 4-Elig-w/Day Supports	$689.49 / 1 Day
Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day
Res Hab-Lic-2 Person-Inelig	$54.05 / 1 Day
Respite-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.
Respite-Unlic-15-min(Lvl 4, 2:1) In-Home	$15.77 / 15 min.
Respite-Unlic-Day (Level 3, 1:1) In-Home	$317.80 / 1 Day
Supplemental Habilitation 1:1 - 15 min	$5.77 / 15 min.
Supplemental Habilitation 2:1 - 15 min	$11.53 / 15 min.

County : Erie
\|Service Name / Level	\|Rate

Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day

County : Fayette
\|Service Name / Level	\|Rate

Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day

County : Forest/Warren
\|Service Name / Level	\|Rate

Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day

County : Franklin/Fulton
\|Service Name / Level	\|Rate

Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day

County : Greene
\|Service Name / Level	\|Rate

Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day

County : Huntingdon/Mifflin/Juniata
\|Service Name / Level	\|Rate

Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day

County : Lackawanna/Susquehanna
\|Service Name / Level	\|Rate

Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day

County : Lancaster
\|Service Name / Level	\|Rate

Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day

County : Lawrence
\|Service Name / Level	\|Rate

Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day

County : Lebanon
\|Service Name / Level	\|Rate

Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day

County : Lehigh
\|Service Name / Level	\|Rate

Behavioral Supports-Level 1-Initial/Ongoing	$22.08 / 15 min.
Behavioral Supports-Level 1-Initial/Ongoing-ECS	$27.10 / 15 min.
Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day

County : Luzerne/Wyoming
\|Service Name / Level	\|Rate

Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day

County : Lycoming/Clinton
\|Service Name / Level	\|Rate

Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day

County : McKean
\|Service Name / Level	\|Rate

Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day

County : Mercer
\|Service Name / Level	\|Rate

Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day

County : Montgomery
\|Service Name / Level	\|Rate

Behavioral Supports-Level 1-Initial/Ongoing	$22.08 / 15 min.
Behavioral Supports-Level 1-Initial/Ongoing-ECS	$27.10 / 15 min.
CPS Community 1:1	$12.81 / 15 min.
CPS Community 1:1 ECS	$14.97 / 15 min.
CPS Community 1:1 Enhanced	$17.83 / 15 min.
CPS Community 1:1 Enhanced ECS	$21.38 / 15 min.
CPS Community 1:2 or 1:3	$6.98 / 15 min.
CPS Community 1:2 or 1:3-ECS	$8.02 / 15 min.
CPS Community 2:1	$24.62 / 15 min.
CPS Community 2:1 ECS	$29.07 / 15 min.
CPS Community 2:1 Enhanced	$29.70 / 15 min.
CPS Community 2:1 Enhanced ECS	$35.43 / 15 min.
CPS Community 2:3	$10.43 / 15 min.
CPS Community 2:3 -ECS	$13.60 / 15 min.
CPS Facility 1:1	$12.40 / 15 min.
CPS Facility 1:1 Enhanced	$17.27 / 15 min.
CPS Facility 1:1 Enhcd LPN	$17.27 / 15 min.
CPS Facility 1:1 Enhcd RN	$17.27 / 15 min.
CPS Facility 1:1 Enhcd-ECS	$20.66 / 15 min.
CPS Facility 1:1-ECS	$14.50 / 15 min.
CPS Facility 1:11 to 1:15	$2.96 / 15 min.
CPS Facility 1:11 to 1:15-ECS	$3.27 / 15 min.
CPS Facility 1:2 to 1:3	$6.84 / 15 min.
CPS Facility 1:2 to 1:3-ECS	$7.90 / 15 min.
CPS Facility 1:4 to 1:6	$5.23 / 15 min.
CPS Facility 1:4 to 1:6-ECS	$6.01 / 15 min.
CPS Facility 1:7 to 1:10	$3.18 / 15 min.
CPS Facility 1:7 to 1:10-ECS	$3.61 / 15 min.
CPS Facility 2:1	$23.77 / 15 min.
CPS Facility 2:1 Enhcd	$28.65 / 15 min.
CPS Facility 2:1 Enhcd LPN	$28.65 / 15 min.
CPS Facility 2:1 Enhcd RN	$28.65 / 15 min.
CPS Facility 2:1 Enhcd-ECS	$34.12 / 15 min.
CPS Facility 2:1-ECS	$27.96 / 15 min.
CPS:Community OnCall/Remote Support	$1.64 / 15 min.
In-Home & Commnty Supprts (Lvl 2 Enh)	$14.18 / 15 min.
In-Home & Commnty Supprts (Lvl 2)	$10.28 / 15 min.
In-Home & Commnty Supprts (Lvl 3 Enh)	$23.74 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$19.83 / 15 min.
Music Therapy	$17.42 / 15 min.
Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day
Respite-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.
Respite-Unlic-15-min(Lvl 4, 2:1) In-Home	$15.77 / 15 min.
Respite-Unlic-Day (Level 3, 1:1) In-Home	$317.80 / 1 Day

County : Northampton
\|Service Name / Level	\|Rate

Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day

County : Northumberland
\|Service Name / Level	\|Rate

Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day

County : Philadelphia
\|Service Name / Level	\|Rate

Behavioral Supports-Level 1-Initial/Ongoing	$22.08 / 15 min.
Behavioral Supports-Level 1-Initial/Ongoing-ECS	$27.10 / 15 min.
CPS Community 1:1	$12.81 / 15 min.
CPS Community 1:1 ECS	$14.97 / 15 min.
CPS Community 1:1 Enhanced	$17.83 / 15 min.
CPS Community 1:2 or 1:3	$6.98 / 15 min.
CPS Community 1:2 or 1:3-ECS	$8.02 / 15 min.
CPS Community 2:1	$24.62 / 15 min.
CPS Community 2:1 ECS	$29.07 / 15 min.
CPS Community 2:1 Enhanced	$29.70 / 15 min.
CPS Community 2:1 Enhanced ECS	$35.43 / 15 min.
CPS Community 2:3	$10.43 / 15 min.
CPS Community 2:3 -ECS	$13.60 / 15 min.
CPS Facility 1:1	$12.40 / 15 min.
CPS Facility 1:1 Enhanced	$17.27 / 15 min.
CPS Facility 1:1 Enhcd LPN	$17.27 / 15 min.
CPS Facility 1:1 Enhcd RN	$17.27 / 15 min.
CPS Facility 1:1 Enhcd-ECS	$20.66 / 15 min.
CPS Facility 1:1-ECS	$14.50 / 15 min.
CPS Facility 1:11 to 1:15	$2.96 / 15 min.
CPS Facility 1:11 to 1:15-ECS	$3.27 / 15 min.
CPS Facility 1:2 to 1:3	$6.84 / 15 min.
CPS Facility 1:2 to 1:3-ECS	$7.90 / 15 min.
CPS Facility 1:4 to 1:6	$5.23 / 15 min.
CPS Facility 1:4 to 1:6-ECS	$6.01 / 15 min.
CPS Facility 1:7 to 1:10	$3.18 / 15 min.
CPS Facility 1:7 to 1:10-ECS	$3.61 / 15 min.
CPS Facility 2:1	$23.77 / 15 min.
CPS Facility 2:1 Enhcd	$28.65 / 15 min.
CPS Facility 2:1 Enhcd LPN	$28.65 / 15 min.
CPS Facility 2:1 Enhcd RN	$28.65 / 15 min.
CPS Facility 2:1 Enhcd-ECS	$34.12 / 15 min.
CPS Facility 2:1-ECS	$27.96 / 15 min.
CPS:Community OnCall/Remote Support	$1.64 / 15 min.
In-Home & Commnty Supprts (Lvl 2)	$10.28 / 15 min.
In-Home & Commnty Supprts (Lvl 3 Enh)	$23.74 / 15 min.
In-Home & Commnty Supprts (Lvl 3)	$19.83 / 15 min.
Music Therapy	$17.42 / 15 min.
Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day
Respite-Unlic-15-min(Level 3, 1:1)In-Home	$7.95 / 15 min.
Respite-Unlic-15-min(Lvl 4, 2:1) In-Home	$15.77 / 15 min.

County : Potter
\|Service Name / Level	\|Rate

Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day

County : Schuylkill
\|Service Name / Level	\|Rate

Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day

County : Tioga
\|Service Name / Level	\|Rate

Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day

County : Venango
\|Service Name / Level	\|Rate

Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day

County : Washington
\|Service Name / Level	\|Rate

Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day

County : Wayne
\|Service Name / Level	\|Rate

Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day

County : Westmoreland
\|Service Name / Level	\|Rate

Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day

County : York/Adams
\|Service Name / Level	\|Rate

Res Hab-Lic-1 Person-Inelig	$99.10 / 1 Day

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