Provider Demographics
NPI:1306456975
Name:BRIGHTON HEART HEALING CENTER LLC
Entity type:Organization
Organization Name:BRIGHTON HEART HEALING CENTER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIGHTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-644-3291
Mailing Address - Street 1:9102 CAPISTRANO ST S UNIT 7208
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34113-3241
Mailing Address - Country:US
Mailing Address - Phone:239-276-9030
Mailing Address - Fax:
Practice Address - Street 1:405 FIFTH AVE S STE 7
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-6515
Practice Address - Country:US
Practice Address - Phone:239-276-9030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-07
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty