1215102512 NPI number — BRIGHT EXPECTATIONS INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215102512 NPI number — BRIGHT EXPECTATIONS INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BRIGHT EXPECTATIONS INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
MANCHESTER DIVISION
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1215102512
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/28/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8175 LIMONITE AVE
Provider Second Line Business Mailing Address:
SUITE C
Provider Business Mailing Address City Name:
RIVERSIDE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92509-6120
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
951-727-4303
Provider Business Mailing Address Fax Number:
951-727-4304

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3921 MANCHESTER PL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RIVERSIDE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92503-4025
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
951-727-4303
Provider Business Practice Location Address Fax Number:
951-727-4304
Provider Enumeration Date:
04/28/2008

Additional Information

Authorized Official

Authorized Official Last Name:
COX
Authorized Official First Name:
HENRY
Authorized Official Middle Name:
CHARLES
Authorized Official Title or Position:
PRESIDENT / ADMINISTRATOR
Authorized Official Telephone Number:
951-727-4303

Provider Taxonomy Codes

  • Taxonomy code: 320900000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: LTC60663F . This is a "MEDI-CAL" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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