Provider Demographics
NPI:1376267773
Name:BRILLIANCE HEALTH STAFFING
Entity Type:Organization
Organization Name:BRILLIANCE HEALTH STAFFING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:FAITH
Authorized Official - Middle Name:WAMBUI
Authorized Official - Last Name:MUCHIRI
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, BSN, RN
Authorized Official - Phone:480-977-7307
Mailing Address - Street 1:793 S SILVERCREEK LN
Mailing Address - Street 2:
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85122-6828
Mailing Address - Country:US
Mailing Address - Phone:480-977-7307
Mailing Address - Fax:
Practice Address - Street 1:793 S SILVERCREEK LN
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-6828
Practice Address - Country:US
Practice Address - Phone:480-977-7307
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-29
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health