Provider Demographics
NPI:1437607694
Name:BRITE LITE HOUSE INC
Entity Type:Organization
Organization Name:BRITE LITE HOUSE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:POURCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-696-0218
Mailing Address - Street 1:3432 NW 86TH WAY
Mailing Address - Street 2:D201
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-6602
Mailing Address - Country:US
Mailing Address - Phone:954-696-0218
Mailing Address - Fax:
Practice Address - Street 1:3432 NW 86TH WAY
Practice Address - Street 2:D201
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-6602
Practice Address - Country:US
Practice Address - Phone:954-696-0218
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-16
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL52A1500008367251B00000X, 251X00000X, 347C00000X, 347E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
No251B00000XAgenciesCase Management
No251X00000XAgenciesSupports Brokerage
No347E00000XTransportation ServicesTransportation Broker