Provider Demographics
NPI:1760570451
Name:MENTAL HEALTH ASSOCIATION IN INDIAN RIVER COUNTY INC
Entity Type:Organization
Organization Name:MENTAL HEALTH ASSOCIATION IN INDIAN RIVER COUNTY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:BRUGNOLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-226-5388
Mailing Address - Street 1:820 37TH PLACE
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-6562
Mailing Address - Country:US
Mailing Address - Phone:772-569-9788
Mailing Address - Fax:772-569-2088
Practice Address - Street 1:820 37TH PLACE
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-6562
Practice Address - Country:US
Practice Address - Phone:772-569-9788
Practice Address - Fax:772-569-2088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health