Brain Restoration Wellness Center, LLC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Legal business name

BRAIN RESTORATION WELLNESS CENTER, LLC

Practice address

22532 Highway 1088
Mandeville, LA 70448-8450

Phone

(985) 674-6650

Fax

(985) 674-4486

NPI assigned

Aug 30, 2013

Organization subpart

No

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

Authorized official

Name

Mark Durel

Title

Director

Phone

(985) 674-6650

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1377820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377820800000",
    "number": "1871927483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22532 HIGHWAY 1088",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704488450",
            "telephone_number": "985-674-6650",
            "fax_number": "985-674-4486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22532 HIGHWAY 1088",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704488450",
            "telephone_number": "985-674-6650",
            "fax_number": "985-674-4486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAIN RESTORATION WELLNESS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-30",
        "last_updated": "2013-08-30",
        "status": "A",
        "authorized_official_last_name": "DUREL",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "985-674-6650"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachael Faith Bowden, LMT
• Michelle M Boze, PSY.D.
• BPC Mandeville
• BPL Enterprises, Inc.
• Maureen C. Bradshaw, LAC
• Elizabeth Caroline Branch, MA,BCBA
• Brand Direct Health LLC
• K Brantley, BS PHARMACY
• Astrid Ann Bratcher, DDS
• Brian Bratcher, O.D.

• Addiction (Substance Use Disorder) Counselor in Mandeville, LA
• Providers in Mandeville, LA by specialty
• Addiction (Substance Use Disorder) Counselor in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2013; 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.