Provider Demographics
NPI:1346903549
Name:BLUE HORIZONS GROUP HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:BLUE HORIZONS GROUP HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JANAE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAHAM BRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:757-920-9120
Mailing Address - Street 1:4317 BONNEY RD # 4
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-1235
Mailing Address - Country:US
Mailing Address - Phone:757-920-9120
Mailing Address - Fax:
Practice Address - Street 1:4317 BONNEY RD # 4
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-1235
Practice Address - Country:US
Practice Address - Phone:757-920-9120
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-15
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
No251300000XAgenciesLocal Education Agency (LEA)
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service