Provider Demographics
NPI:1972316966
Name:BRIGHT LIFE ENHANCEMENT SERVICES,L.L.C
Entity type:Organization
Organization Name:BRIGHT LIFE ENHANCEMENT SERVICES,L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DORA
Authorized Official - Middle Name:
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-446-0010
Mailing Address - Street 1:226 N POTOMAC ST
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-3813
Mailing Address - Country:US
Mailing Address - Phone:410-988-2655
Mailing Address - Fax:
Practice Address - Street 1:226 N POTOMAC ST
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-3813
Practice Address - Country:US
Practice Address - Phone:410-988-2655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BRIGHT LIFE ENHANCEMENT SERVICES,L.L.C
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-01-31
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness