Provider Demographics
NPI:1194054528
Name:BRIGHTER PATH ALABAMA, LLC
Entity type:Organization
Organization Name:BRIGHTER PATH ALABAMA, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:REGIONAL DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:BETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:334-727-2216
Mailing Address - Street 1:4280 US HIGHWAY 29 S
Mailing Address - Street 2:
Mailing Address - City:TUSKEGEE
Mailing Address - State:AL
Mailing Address - Zip Code:36083-5950
Mailing Address - Country:US
Mailing Address - Phone:334-727-2216
Mailing Address - Fax:334-727-2210
Practice Address - Street 1:4280 US HIGHWAY 29 S
Practice Address - Street 2:
Practice Address - City:TUSKEGEE
Practice Address - State:AL
Practice Address - Zip Code:36083-5950
Practice Address - Country:US
Practice Address - Phone:334-727-2216
Practice Address - Fax:334-727-2210
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SYFS SALECO, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-12-14
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility