1306148747 NPI number — BRIGHT BEGINNINGS FAMILY SERVICES,LLC

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 1306148747 NPI number — BRIGHT BEGINNINGS FAMILY SERVICES,LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BRIGHT BEGINNINGS FAMILY SERVICES,LLC
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:
Provider Other Organization Name Type Code:
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:
1306148747
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/17/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
801 W STATE ROAD 436
Provider Second Line Business Mailing Address:
SUITE 2003
Provider Business Mailing Address City Name:
ALTAMONTE SPRINGS
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32714-3054
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
407-834-0000
Provider Business Mailing Address Fax Number:
407-265-2237

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
801 W STATE ROAD 436
Provider Second Line Business Practice Location Address:
SUITE 2003
Provider Business Practice Location Address City Name:
ALTAMONTE SPRINGS
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32714-3054
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
407-834-0000
Provider Business Practice Location Address Fax Number:
407-265-2237
Provider Enumeration Date:
11/17/2010

Additional Information

Authorized Official

Authorized Official Last Name:
BACCHUS
Authorized Official First Name:
LESLIE
Authorized Official Middle Name:
NELSON
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
407-834-0000

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 693510900 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 693510901 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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