Provider Demographics
NPI:1285461228
Name:BRAVE CARE INSTITUTE, INC.
Entity type:Organization
Organization Name:BRAVE CARE INSTITUTE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BELLISARIO
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, PMHNP-BC, CNL
Authorized Official - Phone:888-777-9409
Mailing Address - Street 1:402 W BROADWAY STE 400
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-3554
Mailing Address - Country:US
Mailing Address - Phone:888-777-9409
Mailing Address - Fax:888-999-6614
Practice Address - Street 1:402 W BROADWAY STE 400
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-3554
Practice Address - Country:US
Practice Address - Phone:888-777-9409
Practice Address - Fax:888-999-6614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty