Provider Demographics
NPI:1497196174
Name:BRIGHT BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:BRIGHT BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARASH
Authorized Official - Middle Name:
Authorized Official - Last Name:YAZDANPANAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-826-2890
Mailing Address - Street 1:4880 W UNIVERSITY AVE STE B5
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-3830
Mailing Address - Country:US
Mailing Address - Phone:702-826-2890
Mailing Address - Fax:702-826-2879
Practice Address - Street 1:4880 W UNIVERSITY AVE STE B5
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-3830
Practice Address - Country:US
Practice Address - Phone:702-826-2890
Practice Address - Fax:702-826-2879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-10
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225400000X
NV2000056.062-120251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty