Provider Demographics
NPI:1376222976
Name:BRIGHTER HOPE PSYCHIATRY LLC
Entity Type:Organization
Organization Name:BRIGHTER HOPE PSYCHIATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OMEGA
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:843-373-0569
Mailing Address - Street 1:PO BOX 901
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:SC
Mailing Address - Zip Code:29560-0901
Mailing Address - Country:US
Mailing Address - Phone:843-373-0569
Mailing Address - Fax:
Practice Address - Street 1:378 WALLACE ST
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:SC
Practice Address - Zip Code:29560-4108
Practice Address - Country:US
Practice Address - Phone:843-373-0569
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty