# INTREPID SPIRIT CONCUSSION RECOVERY CENTER

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** NAVAL MEDICAL CENTER CAMP LEJEUNE
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1881168391
- **Legal business name:** NAVAL MEDICAL CENTER CAMP LEJEUNE
- **Authorized official:** WILLIAM M CONDON (UBO MANAGER)
- **Authorized official phone:** (240) 401-3643

## Contact information

- **Practice address:** 100 BREWSTER BLVD, CAMP LEJEUNE, NC 28547-2575
- **Practice address phone:** (910) 449-1100
- **Mailing address:** 100 BREWSTER BLVD, CAMP LEJEUNE, NC 28547-2575

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1100X | Military/U.S. Coast Guard Outpatient Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/17/2019
- **Last updated:** 01/17/2019