Provider Demographics
NPI:1336686229
Name:SOUTH BAY BRIGHT FUTURE, INC.
Entity Type:Organization
Organization Name:SOUTH BAY BRIGHT FUTURE, INC.
Other - Org Name:SOUTH BAY BRIGHT FUTURE, INC.
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LANETA
Authorized Official - Middle Name:JOYCE
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-891-0096
Mailing Address - Street 1:24404 VERMONT AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HARBOR CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90710-2313
Mailing Address - Country:US
Mailing Address - Phone:310-891-0096
Mailing Address - Fax:310-891-0195
Practice Address - Street 1:537 W 8TH ST
Practice Address - Street 2:
Practice Address - City:SAN PEDRO
Practice Address - State:CA
Practice Address - Zip Code:90731-3119
Practice Address - Country:US
Practice Address - Phone:310-891-0096
Practice Address - Fax:310-891-0195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-30
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health