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General NPI Number Information
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NPI Number | 1639066178
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Entity Type | Organization
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Legal Business Name | BRAIN BATH LLC
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Dates
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Enumeration Date | 06/18/2025
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Last Update Date | 02/10/2026
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Provider Practice Location Address
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Address Line | 29532 SOUTHFIELD RD STE 115
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City | SOUTHFIELD
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State | MI
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Zip | 48076-2023
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Country | US
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Telephone | 989-690-1013
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Fax | 313-432-6019
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Provider Business Mailing Address
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Address Line | 2150 HILLHURST AVE
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City | LOS ANGELES
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State | CA
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Zip | 90027-2012
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. NOAH FREIBURGER
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Credential | DNP, PMHNP-BC, CBIS
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Telephone | 989-465-5707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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