Provider Demographics
NPI:1437366085
Name:ADVANCED NEUROSCIENCES INSTITUTE INC
Entity Type:Organization
Organization Name:ADVANCED NEUROSCIENCES INSTITUTE INC
Other - Org Name:ADVANCED NEUROSCIENCES INSTITUTE
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-791-5470
Mailing Address - Street 1:101 FORREST CROSSING BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064
Mailing Address - Country:US
Mailing Address - Phone:615-791-5470
Mailing Address - Fax:615-595-0265
Practice Address - Street 1:101 FORREST CROSSING BLVD STE 103
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064
Practice Address - Country:US
Practice Address - Phone:615-791-5470
Practice Address - Fax:615-595-0265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2022-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN29410174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3374232Medicaid
TN3374232Medicaid