Provider Demographics
NPI:1407449341
Name:BRIGHT SKIES THERAPY CENTER LLC
Entity Type:Organization
Organization Name:BRIGHT SKIES THERAPY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SLP
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:AYERS
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:630-768-5947
Mailing Address - Street 1:561 E GARDEN DR UNIT B
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CO
Mailing Address - Zip Code:80550-3149
Mailing Address - Country:US
Mailing Address - Phone:970-833-5687
Mailing Address - Fax:
Practice Address - Street 1:2918 W 10TH ST UNIT 5
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-5457
Practice Address - Country:US
Practice Address - Phone:970-833-5686
Practice Address - Fax:970-833-5687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-11
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty