Provider Demographics
NPI:1588419048
Name:BRIGHTHOPE LIMITED LIABILITY COMPANY
Entity type:Organization
Organization Name:BRIGHTHOPE LIMITED LIABILITY COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHNNY
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:RUSSELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-364-1541
Mailing Address - Street 1:5545 154TH TER NW
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:MN
Mailing Address - Zip Code:55303-7045
Mailing Address - Country:US
Mailing Address - Phone:612-364-1541
Mailing Address - Fax:
Practice Address - Street 1:5545 154TH TER NW
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:MN
Practice Address - Zip Code:55303-7045
Practice Address - Country:US
Practice Address - Phone:612-364-1541
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-18
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health