Provider Demographics
NPI:1114549698
Name:BRIGHTLIGHT HEALTHCARE LLC
Entity type:Organization
Organization Name:BRIGHTLIGHT HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:IRLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHARLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-933-7914
Mailing Address - Street 1:425 PLEASANT ST STE 101
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-2533
Mailing Address - Country:US
Mailing Address - Phone:508-688-4347
Mailing Address - Fax:508-348-9983
Practice Address - Street 1:425 PLEASANT ST STE 101
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-2533
Practice Address - Country:US
Practice Address - Phone:508-688-4347
Practice Address - Fax:508-348-9983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-07
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health