Provider Demographics
NPI:1164537049
Name:LIMBIC RESOURCES
Entity Type:Organization
Organization Name:LIMBIC RESOURCES
Other - Org Name:THE MEMORY AND ATTENTION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:P
Authorized Official - Last Name:ELOVITZ
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:508-420-9989
Mailing Address - Street 1:PO BOX 1557
Mailing Address - Street 2:
Mailing Address - City:COTUIT
Mailing Address - State:MA
Mailing Address - Zip Code:02635-1557
Mailing Address - Country:US
Mailing Address - Phone:508-420-9989
Mailing Address - Fax:508-420-7460
Practice Address - Street 1:161 HARBOR HILLS RD
Practice Address - Street 2:
Practice Address - City:W HYANNISPORT
Practice Address - State:MA
Practice Address - Zip Code:02672-0274
Practice Address - Country:US
Practice Address - Phone:508-420-9989
Practice Address - Fax:508-420-7460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MALIM21461Medicare ID - Type Unspecified