Healthcare Provider Details

I. General information

NPI: 1346158649
Provider Name (Legal Business Name): BRAT CORPS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2026
Last Update Date: 08/29/2026
Certification Date: 08/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2461 EISENHOWER AVE
ALEXANDRIA VA
22314-4684
US

IV. Provider business mailing address

2461 EISENHOWER AVE
ALEXANDRIA VA
22314-4684
US

V. Phone/Fax

Practice location:
  • Phone: 703-646-8410
  • Fax: 703-646-8410
Mailing address:
  • Phone: 703-646-8410
  • Fax: 703-646-8410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MARUBIAN AFFINII
Title or Position: PRESIDENT
Credential:
Phone: 202-390-1237