Provider Demographics
NPI:1245756238
Name:BRIGHTWAY MENTAL HEALTH CLINIC
Entity Type:Organization
Organization Name:BRIGHTWAY MENTAL HEALTH CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:BRANDY
Authorized Official - Middle Name:D
Authorized Official - Last Name:PREATTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-858-9074
Mailing Address - Street 1:252A HECTOR AVE
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70056-2548
Mailing Address - Country:US
Mailing Address - Phone:504-858-9074
Mailing Address - Fax:
Practice Address - Street 1:252 HECTOR AVE
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70056-2548
Practice Address - Country:US
Practice Address - Phone:504-444-5640
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-21
Last Update Date:2017-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)