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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
1857 WELLS RD STE 216, ORANGE PARK, FL 32073-2340
(904) 523-1287
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
05/13/2025
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