Provider Demographics
NPI:1568006823
Name:BRIGHT FUTURE COMM. HEALTH CARE SVC
Entity type:Organization
Organization Name:BRIGHT FUTURE COMM. HEALTH CARE SVC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMMANUELLA
Authorized Official - Middle Name:E
Authorized Official - Last Name:OWOBU
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:443-912-4612
Mailing Address - Street 1:907 FOXWOOD LN
Mailing Address - Street 2:
Mailing Address - City:ESSEX
Mailing Address - State:MD
Mailing Address - Zip Code:21221-5929
Mailing Address - Country:US
Mailing Address - Phone:443-912-4612
Mailing Address - Fax:
Practice Address - Street 1:404B EASTERN BLVD
Practice Address - Street 2:
Practice Address - City:ESSEX
Practice Address - State:MD
Practice Address - Zip Code:21221-2122
Practice Address - Country:US
Practice Address - Phone:443-912-4612
Practice Address - Fax:877-288-4626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-30
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDBH000992OtherBEHAVIOR HEALTH ADMINISTRATION