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Organization
THE BROKEN BIRD INC.
Active
Organization
THE BROKEN BIRD INC.
Active
Parent organization
501(C)3
Other names
The Broken Bird Inc Counseling Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
501(C)3
Authorized official
DR. CLARA GRAVES HOPKINS ED.D. CAP ICRC-ADC (CEO)
(321) 440-7253
Entity
Organization
Contact information
Practice address
2475 PALM BAY RD NE STE 145, PALM BAY, FL 32905-3362
(321) 440-7253
(321) 473-8426
Mailing address
2475 PALM BAY RD NE STE 145 #27, PALM BAY, FL 32905-3362
(321) 440-7253
(321) 473-8426
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
NULL
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/12/2024
Last updated
09/12/2024
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