Provider Demographics
NPI:1417275157
Name:BRIGHT HORIZONS, LLC
Entity Type:Organization
Organization Name:BRIGHT HORIZONS, LLC
Other - Org Name:HARVEST HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:TEJADA
Authorized Official - Last Name:DEBLOIS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:670-483-8890
Mailing Address - Street 1:PO BOX 503287
Mailing Address - Street 2:GHIYEGHI ST. SAN JOSE
Mailing Address - City:SAIPAN
Mailing Address - State:MP
Mailing Address - Zip Code:96950-3287
Mailing Address - Country:US
Mailing Address - Phone:670-483-8890
Mailing Address - Fax:670-235-4655
Practice Address - Street 1:GHIYEGHI ST. SAN JOSE
Practice Address - Street 2:
Practice Address - City:SAIPAN
Practice Address - State:MP
Practice Address - Zip Code:96950-3287
Practice Address - Country:US
Practice Address - Phone:670-483-8890
Practice Address - Fax:670-235-4655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-05
Last Update Date:2010-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MP19359-0002-1251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health