Provider Demographics
NPI:1184513426
Name:BRIGHT HORIZONS MENTAL HEALTH SERVICES LLC
Entity type:Organization
Organization Name:BRIGHT HORIZONS MENTAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABDIFATAH
Authorized Official - Middle Name:ABDULLAHI
Authorized Official - Last Name:ABDULLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-741-6647
Mailing Address - Street 1:2390 MOUNDS VIEW BLVD APT 133
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55112-0037
Mailing Address - Country:US
Mailing Address - Phone:614-741-6647
Mailing Address - Fax:
Practice Address - Street 1:2390 MOUNDS VIEW BLVD
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55112-4905
Practice Address - Country:US
Practice Address - Phone:614-741-6647
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health