Healthcare Provider Details

I. General information

NPI: 1861352023
Provider Name (Legal Business Name): BRAVO HEALTH PARTNERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2025
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 N WEST ST APT 439
RALEIGH NC
27603-6186
US

IV. Provider business mailing address

202 N WEST ST APT 439
RALEIGH NC
27603-6186
US

V. Phone/Fax

Practice location:
  • Phone: 410-858-6867
  • Fax:
Mailing address:
  • Phone: 410-858-6867
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: VANESSA BELL
Title or Position: CEO / PROGRAM DIRECTOR & CERTIFIED
Credential: CPSS
Phone: 410-858-6867