Healthcare Provider Details

I. General information

NPI: 1356276000
Provider Name (Legal Business Name): BRAIN BATH NURSING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 HILLHURST AVE
LOS ANGELES CA
90027-2012
US

IV. Provider business mailing address

2150 HILLHURST AVE
LOS ANGELES CA
90027-2012
US

V. Phone/Fax

Practice location:
  • Phone: 989-465-5707
  • Fax: 313-432-6019
Mailing address:
  • Phone: 989-465-5707
  • Fax: 313-432-6019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MR. NOAH FREIBURGER
Title or Position: OWNER
Credential: DNP, PHMNP-BC, CBIS
Phone: 989-465-5707