1518692763 NPI number — BRIGHTER DAY ADULT SERVICES LLC

Table of content: (NPI 1518692763)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518692763 NPI number — BRIGHTER DAY ADULT SERVICES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BRIGHTER DAY ADULT 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:
1518692763
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/30/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3021 CHISLET DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MIDLOTHIAN
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23112-3403
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
804-625-5746
Provider Business Mailing Address Fax Number:
833-838-9829

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1716 POCOSHOCK BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH CHESTERFIELD
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23235-5612
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-658-5377
Provider Business Practice Location Address Fax Number:
833-838-9829
Provider Enumeration Date:
07/21/2022

Additional Information

Authorized Official

Authorized Official Last Name:
SPRUILL
Authorized Official First Name:
DEMETRIUS
Authorized Official Middle Name:
Authorized Official Title or Position:
MEMBER
Authorized Official Telephone Number:
804-625-5746

Provider Taxonomy Codes

  • Taxonomy code: 323P00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 320800000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com