MEDICARE: BRAVO HEALTH PARTNERS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1861352023
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRAVO HEALTH PARTNERS LLC

Provider Business Mailing Address
First Line	:	202 N WEST ST APT 439
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27603-6186
Country	:	US
Telephone Number	:	410-858-6867
Fax Number	:

Provider Business Practice Location Address
First Line	:	202 N WEST ST APT 439
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27603-6186
Country	:	US
Telephone Number	:	410-858-6867
Fax Number	:

Authorized Official
Title or Position	:	CEO / PROGRAM DIRECTOR & CERTIFIED
Name	:	VANESSA BELL
Credential	:	CPSS
Telephone Number	:	410-858-6867

Provider Enumeration Date	:	11/12/2025
Last Update Date	:	05/14/2026

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