Healthcare Provider Details

I. General information

NPI: 1780252700
Provider Name (Legal Business Name): BE COURAGEOUS INCOPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2021
Last Update Date: 08/24/2025
Certification Date: 08/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5224 LINTON ST
SOUTH BLOOMFIELD OH
43103-3500
US

IV. Provider business mailing address

5224 LINTON ST
SOUTH BLOOMFIELD OH
43103-3500
US

V. Phone/Fax

Practice location:
  • Phone: 614-641-1577
  • Fax:
Mailing address:
  • Phone: 614-641-1577
  • 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: MR. DONALD L. GARRISON JR.
Title or Position: CEO
Credential:
Phone: 614-641-1577