Provider Demographics
NPI:1457504060
Name:BRAVIS ENTERPRISES INC
Entity Type:Organization
Organization Name:BRAVIS ENTERPRISES INC
Other - Org Name:BUTLER REHABILITATION CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:RPSGT
Authorized Official - Phone:724-282-0755
Mailing Address - Street 1:1610 N MAIN STREET EXT
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-1513
Mailing Address - Country:US
Mailing Address - Phone:724-282-0755
Mailing Address - Fax:724-282-7723
Practice Address - Street 1:1610 N MAIN STREET EXT
Practice Address - Street 2:SUITE 101
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-1513
Practice Address - Country:US
Practice Address - Phone:724-282-0755
Practice Address - Fax:724-282-7723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-28
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA087537Medicare Oscar/Certification