Provider Demographics
NPI:1083077432
Name:BRIGHTON HEALTHCARE LLC
Entity Type:Organization
Organization Name:BRIGHTON HEALTHCARE LLC
Other - Org Name:BRIGHTON HEALTHCARE AT HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER & EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MURDINA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SHEPHERD
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:678-695-8186
Mailing Address - Street 1:909 SENOIA RD
Mailing Address - Street 2:STE C
Mailing Address - City:TYRONE
Mailing Address - State:GA
Mailing Address - Zip Code:30290-6805
Mailing Address - Country:US
Mailing Address - Phone:678-695-8186
Mailing Address - Fax:866-562-1217
Practice Address - Street 1:909 SENOIA RD
Practice Address - Street 2:STE C
Practice Address - City:TYRONE
Practice Address - State:GA
Practice Address - Zip Code:30290-6805
Practice Address - Country:US
Practice Address - Phone:678-695-8186
Practice Address - Fax:866-562-1217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-02
Last Update Date:2016-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care