Provider Demographics
NPI:1275793176
Name:BRIGHTSTAR OF WEST MICHIGAN
Entity Type:Organization
Organization Name:BRIGHTSTAR OF WEST MICHIGAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BERNIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-447-6700
Mailing Address - Street 1:2666 ALPINE AVE NW
Mailing Address - Street 2:SUITE B
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49544-1970
Mailing Address - Country:US
Mailing Address - Phone:616-447-6700
Mailing Address - Fax:
Practice Address - Street 1:2666 ALPINE AVE NW
Practice Address - Street 2:SUITE B
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49544-1970
Practice Address - Country:US
Practice Address - Phone:616-447-6700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-13
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health