BRAVE GRAND RAPIDS LLC NPI 1285086900

NPI Information

NPI: 1285086900
Provider Name: BRAVE GRAND RAPIDS LLC

Other Name: BRAVE GR

Classification: Counselor - 101YP2500X
Entity Type: Organization

Specialization: Professional

Address:
103 COLLEGE AVE SE
GRAND RAPIDS, MI
ZIP 49503
Phone: (616) 419-8628
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BRAVE GRAND RAPIDS LLC is a professional counselor in Grand Rapids, MI. BRAVE GRAND RAPIDS LLC NPI is 1285086900. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Brave Gr.

The provider's business location address is:

103 COLLEGE AVE SE
GRAND RAPIDS, MI
ZIP 49503-921
Phone: (616) 419-8628

The provider's authorized official is Allison Kyle Waldron .
The authorized official title is Manager and has the following contact phone number (616) 419-8628.

The enumeration date for this NPI number is 7/6/2016 and was last updated on 10/5/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YP2500X	Counselor	Professional	6401015446	MICHIGAN	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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