Provider Demographics
NPI:1124855218
Name:BRIGHTSIDE CARE
Entity type:Organization
Organization Name:BRIGHTSIDE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KAMAL
Authorized Official - Middle Name:MOHAMED
Authorized Official - Last Name:JAMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-374-8751
Mailing Address - Street 1:601 CARLSON PKWY STE 1050
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55305-5219
Mailing Address - Country:US
Mailing Address - Phone:651-374-8751
Mailing Address - Fax:
Practice Address - Street 1:601 CARLSON PKWY STE 1050
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305-5219
Practice Address - Country:US
Practice Address - Phone:651-374-8751
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-13
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care