Provider Demographics
NPI:1679714653
Name:ANNAPURNA INSTITUTE, INC.
Entity Type:Organization
Organization Name:ANNAPURNA INSTITUTE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREAS
Authorized Official - Middle Name:S
Authorized Official - Last Name:BRAUN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, PHD
Authorized Official - Phone:772-589-4886
Mailing Address - Street 1:PO BOX 1021
Mailing Address - Street 2:
Mailing Address - City:ROSELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32957-1021
Mailing Address - Country:US
Mailing Address - Phone:772-589-4886
Mailing Address - Fax:772-589-9027
Practice Address - Street 1:735 COMMERCE CENTER DR STE A
Practice Address - Street 2:
Practice Address - City:SEBASTIAN
Practice Address - State:FL
Practice Address - Zip Code:32958-3136
Practice Address - Country:US
Practice Address - Phone:772-589-4488
Practice Address - Fax:772-589-9027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-20
Last Update Date:2009-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH1720101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty