Provider Demographics
NPI:1588049019
Name:BRIGHTON CORNERSTONE GROUP, LLC
Entity type:Organization
Organization Name:BRIGHTON CORNERSTONE GROUP, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:D
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:NHA
Authorized Official - Phone:731-588-4302
Mailing Address - Street 1:55 E NORTH ST
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42431-1643
Mailing Address - Country:US
Mailing Address - Phone:270-821-1492
Mailing Address - Fax:270-821-6946
Practice Address - Street 1:55 E NORTH ST
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:KY
Practice Address - Zip Code:42431-1643
Practice Address - Country:US
Practice Address - Phone:270-821-1492
Practice Address - Fax:270-821-6946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-27
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY100183314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100364100Medicaid
KY7100364100Medicaid