Provider Demographics
NPI:1174035455
Name:BRIGHT MORNING STAR MINISTRIES
Entity Type:Organization
Organization Name:BRIGHT MORNING STAR MINISTRIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM MGR/COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:JEANETTE
Authorized Official - Last Name:GLASTER
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:692-978-6752
Mailing Address - Street 1:2650 S FORUM DR APT 19102
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-7051
Mailing Address - Country:US
Mailing Address - Phone:972-854-6186
Mailing Address - Fax:
Practice Address - Street 1:707 NORTH FWY STE 111
Practice Address - Street 2:
Practice Address - City:FT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76102-1702
Practice Address - Country:US
Practice Address - Phone:682-978-6752
Practice Address - Fax:214-810-8824
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-26
Last Update Date:2017-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty