Provider Demographics
NPI:1386443265
Name:COGNITIVE FUNCTION DEVELOPMENT INSTITUTE, INC.
Entity type:Organization
Organization Name:COGNITIVE FUNCTION DEVELOPMENT INSTITUTE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO / DIRECTOR OF R&D
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BEYST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-251-0851
Mailing Address - Street 1:6895 E LYNX WAGON RD
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86314-1932
Mailing Address - Country:US
Mailing Address - Phone:507-251-0851
Mailing Address - Fax:928-515-2278
Practice Address - Street 1:COGNITIVE FUNCTION DEVELOPMENT INSTITUTE
Practice Address - Street 2:3250 GATEWAY BLVD, SUITE 200
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86303
Practice Address - Country:US
Practice Address - Phone:507-251-0851
Practice Address - Fax:928-515-2278
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRANSFORMATIONAL OPPORTUNITIES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)