Organization
BRAVE HEARTS WELLLNESS CENTER INC
Active
Organization
BRAVE HEARTS WELLLNESS CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENIA N. DAVILA ORTIZ MHC (OWNER/ PRESIDENT)
(904) 523-1287
Entity
Organization
Contact information
Practice address
1855 WELLS RD STE 1, ORANGE PARK, FL 32073-6766
(904) 523-1287
(904) 615-6919
Mailing address
1857 WELLS RD STE 216, ORANGE PARK, FL 32073-2340
(904) 523-1287
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP1600X
Pastoral Counselor
—
—
101YP2500X
Professional Counselor
—
—
103TC0700X
Clinical Psychologist
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
08/30/2024
Last updated
06/09/2026
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