Provider Demographics
NPI:1528743911
Name:A BRIGHTER LIFE,LLC
Entity type:Organization
Organization Name:A BRIGHTER LIFE,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:HINES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-672-0688
Mailing Address - Street 1:900 GRANBY ST STE 262
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23510-2594
Mailing Address - Country:US
Mailing Address - Phone:757-578-5067
Mailing Address - Fax:
Practice Address - Street 1:900 GRANBY ST STE 262
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23510-2594
Practice Address - Country:US
Practice Address - Phone:757-578-5067
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-21
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health