Provider Demographics
NPI:1801772140
Name:BRAINCARE PERFORMANCE CENTER - PENSACOLA LLC
Entity type:Organization
Organization Name:BRAINCARE PERFORMANCE CENTER - PENSACOLA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HABERBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-619-7109
Mailing Address - Street 1:9013 UNIVERSITY PKWY STE H
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-9421
Mailing Address - Country:US
Mailing Address - Phone:757-619-7109
Mailing Address - Fax:
Practice Address - Street 1:9013 UNIVERSITY PKWY STE H
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514-9421
Practice Address - Country:US
Practice Address - Phone:757-619-7109
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)