Provider Demographics
NPI:1386106730
Name:BRIGHT FUTURES ABA THERAPY, LLC
Entity type:Organization
Organization Name:BRIGHT FUTURES ABA THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:THORNTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-790-2003
Mailing Address - Street 1:130 MONTREAT CT
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36303-6320
Mailing Address - Country:US
Mailing Address - Phone:334-790-2003
Mailing Address - Fax:
Practice Address - Street 1:526 BOLL WEEVIL CIR STE A
Practice Address - Street 2:
Practice Address - City:ENTERPRISE
Practice Address - State:AL
Practice Address - Zip Code:36330-4012
Practice Address - Country:US
Practice Address - Phone:334-701-2475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-04
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty