Provider Demographics
NPI:1093384224
Name:BRIGHT FUTURES OF VIRGINIA, LLC
Entity type:Organization
Organization Name:BRIGHT FUTURES OF VIRGINIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO/PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:QMHP
Authorized Official - Phone:804-874-6177
Mailing Address - Street 1:1701 JACQUELIN ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23220-6465
Mailing Address - Country:US
Mailing Address - Phone:804-874-6177
Mailing Address - Fax:804-270-5821
Practice Address - Street 1:1701 JACQUELIN ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23220-6465
Practice Address - Country:US
Practice Address - Phone:804-874-6177
Practice Address - Fax:804-270-5821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-22
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty