Provider Demographics
NPI:1346699154
Name:INSTITUTE FOR THE SCIENCE OF EMOTIONS AND CONDUCT LLC
Entity Type:Organization
Organization Name:INSTITUTE FOR THE SCIENCE OF EMOTIONS AND CONDUCT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:ELBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ORELLANA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:616-822-7036
Mailing Address - Street 1:2175 SEDONA HILLS PKWY
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-4135
Mailing Address - Country:US
Mailing Address - Phone:616-822-7036
Mailing Address - Fax:
Practice Address - Street 1:2175 SEDONA HILLS PKWY
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-4135
Practice Address - Country:US
Practice Address - Phone:616-822-7036
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-13
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2084B0040X
NMMD2014-0115273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes273R00000XHospital UnitsPsychiatric UnitGroup - Single Specialty
No2084B0040XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBehavioral Neurology & NeuropsychiatryGroup - Single Specialty