Provider Demographics
NPI:1497399281
Name:MINDBRIGHT LLC
Entity Type:Organization
Organization Name:MINDBRIGHT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BROOKE
Authorized Official - Middle Name:
Authorized Official - Last Name:OBER
Authorized Official - Suffix:
Authorized Official - Credentials:SLP, CCC
Authorized Official - Phone:406-871-1524
Mailing Address - Street 1:810 OBRIEN AVE
Mailing Address - Street 2:
Mailing Address - City:WHITEFISH
Mailing Address - State:MT
Mailing Address - Zip Code:59937-2943
Mailing Address - Country:US
Mailing Address - Phone:406-871-1524
Mailing Address - Fax:
Practice Address - Street 1:50 2ND ST W
Practice Address - Street 2:
Practice Address - City:WHITEFISH
Practice Address - State:MT
Practice Address - Zip Code:59937-3064
Practice Address - Country:US
Practice Address - Phone:406-871-1524
Practice Address - Fax:406-730-2628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-05
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty