Brain Disorder Support Foundation, Inc.

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

License

AHCA #9115 Issued in FL

Legal business name

BRAIN DISORDER SUPPORT FOUNDATION, INC.

Doing business as

Friendship House BDSF

Practice address

353 Juniper Lake Rd
Defuniak Springs, FL 32433-3514

Phone

(850) 892-0565

Fax

(850) 520-4651

NPI assigned

Aug 9, 2012

Last updated

Aug 9, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Hilda R Coursey

Title

Administratot

Phone

(850) 892-0565

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Friendship House BDSF Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1344470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344470400000",
    "number": "1558618454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 JUNIPER LAKE RD",
            "city": "DEFUNIAK SPRINGS",
            "state": "FL",
            "postal_code": "324333514",
            "telephone_number": "850-892-0565",
            "fax_number": "850-520-4651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 JUNIPER LAKE RD",
            "city": "DEFUNIAK SPRINGS",
            "state": "FL",
            "postal_code": "324333514",
            "telephone_number": "850-892-0565",
            "fax_number": "850-520-4651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAIN DISORDER SUPPORT FOUNDATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-09",
        "last_updated": "2012-08-09",
        "status": "A",
        "authorized_official_last_name": "COURSEY",
        "authorized_official_first_name": "HILDA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "ADMINISTRATOT",
        "authorized_official_telephone_number": "850-892-0565",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "FL",
            "license": "AHCA #9115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL  AHCA LICENSE",
            "identifier": "9115",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Friendship House BDSF",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kadyn Brooke Beagles, RBT
• Amber Beasley
• Lynn L Beaver
• Lauren Elizabeth Bell
• Kennedy Chrystian Boggs
• Lauren Brannon, RBT
• Melissa Ruth Brannon, R.D., L.D.N.
• Vida L Brinson, LMHC
• Jacquelyn Joy Broadus, LMHC
• Lily Rain Brooks

• Adult Day Care Clinic/Center in Defuniak Springs, FL
• Providers in Defuniak Springs, FL by specialty
• Adult Day Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.