Provider Demographics
NPI:1801595582
Name:CRUCIAN BEHAVIORAL SERVICES LLC.
Entity type:Organization
Organization Name:CRUCIAN BEHAVIORAL SERVICES LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FRANCILLIA
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANCIS-BEVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-410-1658
Mailing Address - Street 1:110 E SUFFOLK AVE
Mailing Address - Street 2:
Mailing Address - City:CENTRAL ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11722-2440
Mailing Address - Country:US
Mailing Address - Phone:631-408-8158
Mailing Address - Fax:
Practice Address - Street 1:110 E SUFFOLK AVE
Practice Address - Street 2:
Practice Address - City:CENTRAL ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11722-2440
Practice Address - Country:US
Practice Address - Phone:631-408-8158
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-01
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty