| Organization Name: | BRAIN FIT ACADEMY, INC |
| NPI Number: | 1568851368 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PAMELA MARIE FORMOSA (OCCUPATIONAL THERAPIST) |
| Mailing Address: | 25 Westcott Rd Hopedale |
| State: | MA US |
| Postal Code: | 017471824 |
| Phone Number: | 5084781031 |
| Fax Number: | |
| NPI Enumeration Date: | 01/16/2015 |
| NPI Last Update Date: | 01/16/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM1300X |
| License Number: | 2461 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Multi-Specialty |
| Taxonomy Definition: | |