Provider Demographics
NPI:1518248467
Name:NEURO SCIENCE INSTITUTE
Entity Type:Organization
Organization Name:NEURO SCIENCE INSTITUTE
Other - Org Name:CROSBY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-385-9399
Mailing Address - Street 1:11828 RANCHO BERNARDO RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-1912
Mailing Address - Country:US
Mailing Address - Phone:858-385-9456
Mailing Address - Fax:858-385-9456
Practice Address - Street 1:11828 RANCHO BERNARDO RD
Practice Address - Street 2:SUITE 201
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-1912
Practice Address - Country:US
Practice Address - Phone:858-385-9456
Practice Address - Fax:858-385-9456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness