Provider Demographics
NPI:1124567284
Name:BRIGHT HORIZONS BEHAVIORAL HEALTH INCORPORATED
Entity Type:Organization
Organization Name:BRIGHT HORIZONS BEHAVIORAL HEALTH INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-288-3314
Mailing Address - Street 1:3531 WASHINGTON BLVD STE 220-240
Mailing Address - Street 2:
Mailing Address - City:HALETHORPE
Mailing Address - State:MD
Mailing Address - Zip Code:21227-1603
Mailing Address - Country:US
Mailing Address - Phone:571-288-3314
Mailing Address - Fax:888-760-4333
Practice Address - Street 1:3531 WASHINGTON BLVD STE 220-240
Practice Address - Street 2:
Practice Address - City:HALETHORPE
Practice Address - State:MD
Practice Address - Zip Code:21227-1603
Practice Address - Country:US
Practice Address - Phone:104-204-8971
Practice Address - Fax:888-760-4333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-21
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD906454251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health