BRAVO HEALTH SERVICE, INC (NPI# 1649804717) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649804717 |
| Entity Type | Organization |
| Organization Name | BRAVO HEALTH SERVICE, INC |
| Practice Address |
2104 Park Ave Minneapolis MN 55404-6607 |
| Practice Telephone | 6122952979 |
| Mailing Telephone | 6122952979 |
| Enumeration Date | 2020-02-27 |
| Last Update Date | 2020-02-27 |
| Authorized Official Name | NASIR A BARKHADLE (OWNER) |
| Authorized Official Telephone | 6122952979 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Bravo Health Service, Inc | Doing Business As Name - Organization |
| Street Address |
2104 PARK AVE |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55404-6607 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225082233 | First Choice Home Care Inc | Home Health | 2104 Park Ave, Minneapolis, MN 55404-6607 | 2006-05-22 |
| 1609489517 | River Crossings Counseling and Consulting LLC | Community/Behavioral Health | 2104 Park Ave, Minneapolis, MN 55404-6607 | 2020-08-28 |
| 1437789716 | Lifetrack Wellness Inc | Early Intervention Provider Agency | 2104 Park Ave, Minneapolis, MN 55404-6607 | 2020-01-25 |
| 1326681511 | Eagle Group Home | Home Health | 2104 Park Ave, Minneapolis, MN 55404-6607 | 2019-10-21 |
| 1679114144 | Priomh Healing Services Inc | Clinic/Center | 2104 Park Ave, Minneapolis, MN 55404-6607 | 2019-10-04 |
| 1114391513 | Michelle Austin | Social Worker | 2104 Park Ave, Minneapolis, MN 55404-6607 | 2015-11-23 |
| 1992043145 | Pt Works, LLC | Clinic/Center | 2104 Park Ave, Minneapolis, MN 55404-2847 | 2013-01-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568062461 | Andrew Moe | Counselor | 2118 Blaisdell Ave S., Minneapolis, MN 55404 | 2020-10-29 |
| 1194368191 | Luz Angelica Fehn Salinas | Psychologist | 1315 E24th St, Minneapolis, MN 55404 | 2019-10-22 |
| 1760969125 | Bethany Karen Kenny | Registered Nurse | 910 E 26th St Ste 200, Minneapolis, MN 55404 | 2018-07-27 |
| 1225535701 | Karissa Dougherty | Nurse Practitioner | 2200 E Franklin Ave # 199, Minneapolis, MN 55404 | 2018-04-10 |
| 1891299491 | Guidance Home Health Care LLC | Home Health | 2529 Nicollet Avenue 202b, Minneapolis, MN 55404 | 2018-03-20 |
| 1770085490 | Bright Future Counseling Service, LLC | Counselor | 912 E. 24th St., Suite B215, Minneapolis, MN 55404 | 2018-03-08 |
| 1346754298 | Juba Pharmacy Inc | Pharmacy | 1926 Chicago Ave S, Minneapolis, MN 55404 | 2017-11-29 |
| 1629597323 | Kira Larson Fieldstrom | Social Worker | 2400 Blaisdell Ave., Minneapolis, MN 55404 | 2017-09-13 |
| 1770008930 | Nicole Lynn Sparks | Social Worker | 2445 Park Avenue, Minneapolis, MN 55404 | 2017-08-09 |
| 1639612765 | Cosmo Home Healthcare Services, L.L.C. | Home Health | 2219 Oakland Ave S, Suite 104, Minneapolis, MN 55404 | 2016-11-21 |
| Find all providers in zip 55404 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205433984 | Hopebridge Life Skills Center | Clinic/Center | 3617 E Lake St, Minneapolis, MN 55406-2148 | 2020-10-05 |
| 1801404637 | Golden Health LLC | Clinic/Center | 3601 Phillips Pkwy Apt 116, Minneapolis, MN 55426-3800 | 2020-07-17 |
| 1720562812 | Axisspoint Inc | Clinic/Center | 2021 E Hennepin Ave Ste 193, Minneapolis, MN 55413-1773 | 2018-09-24 |
| 1295213759 | Kathleen Healthcare Center | Clinic/Center | 2647 Bloomington Ave, Minneapolis, MN 55407-1187 | 2018-08-06 |
| 1730672106 | Koru Holistic Counseling | Clinic/Center | 314 Clifton Ave Ste 10, Minneapolis, MN 55403-3384 | 2018-06-11 |
| 1043700800 | Roots Therapy & Consulting LLC | Clinic/Center | 2920 Bryant Ave S Ste 112, Minneapolis, MN 55408-2332 | 2018-05-16 |
| 1093216848 | Cure Care Psychotherapy LLC | Clinic/Center | 730 E 38th St Ste 201, Minneapolis, MN 55407-5235 | 2018-02-27 |
| 1801308077 | Nicole J Wolf Phd Lp | Clinic/Center | 4749 Chicago Ave Ste 1a, Minneapolis, MN 55407-4181 | 2017-10-27 |
| 1386953974 | Water's Edge Psychotherapy, LLC | Clinic/Center | 3617 45th Ave S, Minneapolis, MN 55406-2928 | 2010-09-29 |
| 1992934392 | Morningsong Therapy Center Inc | Clinic/Center | 25 W. Diamond Lake Road, Minneapolis, MN 55419 | 2009-07-07 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55404 |
Please comment or provide details below to improve the information on BRAVO HEALTH SERVICE, INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.