Provider Demographics
NPI:1588404529
Name:BRIGHTLITE BEHAVIORAL HEALTH LLC
Entity type:Organization
Organization Name:BRIGHTLITE BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OF ENTITY
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:ADETOLA
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, CRNP
Authorized Official - Phone:410-672-7028
Mailing Address - Street 1:1829 REISTERSTOWN RD # 325
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-6320
Mailing Address - Country:US
Mailing Address - Phone:443-901-3777
Mailing Address - Fax:443-901-3787
Practice Address - Street 1:1829 REISTERSTOWN RD # 325
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-6320
Practice Address - Country:US
Practice Address - Phone:443-901-3777
Practice Address - Fax:443-901-3787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-28
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty