Brain Injury Behavioral Support Concepts, Inc,

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

BRAIN INJURY BEHAVIORAL SUPPORT CONCEPTS, INC,

Practice address

8000 SW Greenhouse LN
Portland, OR 97225-3869

Phone

(503) 200-4057

Fax

(503) 200-1400

NPI assigned

Mar 26, 2021

Organization subpart

No

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

Authorized official

Name

Marie Gallina

Title

President

Phone

(503) 200-4057

Specialties & licenses 1

Addresses

Other names 1

• Opportunity House Doing business as

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

{
    "created_epoch": "1616716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616716800000",
    "number": "1962089755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8000 SW GREENHOUSE LN",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972253869",
            "telephone_number": "503-200-4057",
            "fax_number": "503-200-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8000 SW GREENHOUSE LN",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972253869",
            "telephone_number": "503-200-4057",
            "fax_number": "503-200-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAIN INJURY BEHAVIORAL SUPPORT CONCEPTS, INC,",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-26",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A",
        "authorized_official_last_name": "GALLINA",
        "authorized_official_first_name": "MARIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-200-4057"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Opportunity House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tracy Bragg
• Kacie Ann-Louise Braham, L.M.T.
• Ameet S Brahmavar, MD
• John Aron Braide, L.AC.
• Braided River Counseling LLC
• Brain Rehabilitation Medicine
• Ashley Nicole Brainard, MA, QMHP
• Joseph Cody Brainard, DPT
• Braincare, LLC
• Heather Braman, LMT

• Adult Mental Health Clinic/Center in Portland, OR
• Providers in Portland, OR by specialty
• Adult Mental Health Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2021; 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.