Provider Demographics
NPI:1316579873
Name:BRIGHTWAY PROFESSIONALS AND ASSOCIATES
Entity Type:Organization
Organization Name:BRIGHTWAY PROFESSIONALS AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BAYO
Authorized Official - Middle Name:
Authorized Official - Last Name:AKINTIMEHIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-674-8695
Mailing Address - Street 1:4810 ST.BARNABAS RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:TEMPLE HILLS
Mailing Address - State:MD
Mailing Address - Zip Code:20748
Mailing Address - Country:US
Mailing Address - Phone:202-719-2989
Mailing Address - Fax:
Practice Address - Street 1:4810 ST.BARNABAS RD
Practice Address - Street 2:SUITE 201
Practice Address - City:TEMPLE HILLS
Practice Address - State:MD
Practice Address - Zip Code:20748
Practice Address - Country:US
Practice Address - Phone:202-719-2989
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-12
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities