The Brevard Health Alliance Inc

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

THE BREVARD HEALTH ALLIANCE INC

Practice address

705 Blake Ave
BLDG G
Cocoa, FL 32922-7100

Phone

(321) 633-6391

Fax

(321) 633-6441

NPI assigned

Oct 16, 2008

Organization subpart

No

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

Authorized official

Name

Angela Craig

Title

Business Office Manager

Phone

(321) 952-9696

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Monroe Center Other name

Locations

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

{
    "created_epoch": "1224115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268006400000",
    "number": "1730331109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 BLAKE AVE",
            "address_2": "BLDG G",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329227100",
            "telephone_number": "321-633-6391",
            "fax_number": "321-633-6441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 BLAKE AVE",
            "address_2": "BLDG G",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329227100",
            "telephone_number": "321-633-6391",
            "fax_number": "321-633-6441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BREVARD HEALTH ALLIANCE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-16",
        "last_updated": "2010-03-08",
        "status": "A",
        "authorized_official_last_name": "CRAIG",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "321-952-9696"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6886931-10",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Monroe Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kelli Michelle Strobel, RNFA, CNOR, ONC
• Susan Sullivan, PHD
• Jillian Sweat
• The Brevard Health Alliance Inc (Brevard Health Alliance)
• The Brevard Health Alliance Inc
• The Brevard Health Alliance Inc (Brevard Health Alliance)
• The Devereux Foundation
• Alexas Thomas
• Rachel Ruthann Thomas, RBT
• Stevette Thomas

• Federally Qualified Health Center (FQHC) in Cocoa, FL
• Providers in Cocoa, FL by specialty
• Federally Qualified Health Center (FQHC) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2010; 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.