=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356276000
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BRAIN BATH NURSING INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/15/2026
-----------------------------------------------------
Last Update Date | 06/15/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2150 HILLHURST AVE
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90027-2012
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 989-465-5707
-----------------------------------------------------
Fax | 313-432-6019
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2150 HILLHURST AVE
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90027-2012
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 989-465-5707
-----------------------------------------------------
Fax | 313-432-6019
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MR. NOAH FREIBURGER
-----------------------------------------------------
Credential | DNP, PHMNP-BC, CBIS
-----------------------------------------------------
Telephone | 989-465-5707
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------