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General NPI Number Information
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NPI Number | 1215860978
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Entity Type | Organization
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Legal Business Name | BRAVE STAR HEALTH INC
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Dates
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Enumeration Date | 06/03/2026
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Last Update Date | 06/03/2026
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Provider Practice Location Address
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Address Line | 2828 N CENTRAL AVE STE 1000
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City | PHOENIX
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State | AZ
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Zip | 85004-1027
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Country | US
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Telephone | 718-935-9400
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Fax | 347-435-2488
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Provider Business Mailing Address
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Address Line | 755 KENT AVE APT 713
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City | BROOKLYN
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State | NY
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Zip | 11249-8210
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Country | US
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Telephone | 718-935-9400
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Fax | 347-435-2488
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Authorized Official
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Title or Position | ADMIN
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Name | FAIGY SCHNEEBALG
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Credential |
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Telephone | 718-504-0021
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State |
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