Provider Demographics
NPI:1316546575
Name:BRIGHTERLIFE HEALTHCARE SERVICES INC
Entity Type:Organization
Organization Name:BRIGHTERLIFE HEALTHCARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AHAOMA
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:NNEBEDUM
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:240-467-0628
Mailing Address - Street 1:1904 ROBERT BOWIE DR
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-5667
Mailing Address - Country:US
Mailing Address - Phone:240-467-0628
Mailing Address - Fax:
Practice Address - Street 1:10903 INDIAN HEAD HWY STE 504
Practice Address - Street 2:
Practice Address - City:FT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-4012
Practice Address - Country:US
Practice Address - Phone:240-493-4704
Practice Address - Fax:301-753-7003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-20
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty