Organization
THE BREVARD HEALTH ALLIANCE INC
Active
Other names
Monroe Center
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA CRAIG (BUSINESS OFFICE MANAGER)
(321) 952-9696
Entity
Organization
Contact information
Practice address
705 BLAKE AVE, BLDG G, COCOA, FL 32922-7100
(321) 633-6391
(321) 633-6441
Mailing address
705 BLAKE AVE, BLDG G, COCOA, FL 32922-7100
(321) 633-6391
(321) 633-6441
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6886931-10
—
FL
Enumeration date
10/16/2008
Last updated
03/08/2010
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