Provider Demographics
NPI:1447372636
Name:NEURO DEVELOPMENT CENTER, INC
Entity type:Organization
Organization Name:NEURO DEVELOPMENT CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURENCE
Authorized Official - Middle Name:M
Authorized Official - Last Name:HIRSHBERG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:401-351-7779
Mailing Address - Street 1:260 W EXCHANGE ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-1000
Mailing Address - Country:US
Mailing Address - Phone:401-351-7779
Mailing Address - Fax:401-351-8188
Practice Address - Street 1:260 W EXCHANGE ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-1000
Practice Address - Country:US
Practice Address - Phone:401-351-7779
Practice Address - Fax:401-351-8188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty