Provider Demographics
NPI:1235260225
Name:BRIGHT CARE HOME HEALTH PROVIDER
Entity Type:Organization
Organization Name:BRIGHT CARE HOME HEALTH PROVIDER
Other - Org Name:HOLISTIC CARE HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:BHAVNA
Authorized Official - Middle Name:
Authorized Official - Last Name:UPPAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-481-7000
Mailing Address - Street 1:1131 W 6TH ST STE 232
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91762-1126
Mailing Address - Country:US
Mailing Address - Phone:909-986-7538
Mailing Address - Fax:909-986-0218
Practice Address - Street 1:9269 UTICA AVENUE
Practice Address - Street 2:SUITE 170
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730
Practice Address - Country:US
Practice Address - Phone:909-481-7000
Practice Address - Fax:909-481-7778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2019-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550000863251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA059132Medicare PIN