Provider Demographics
NPI:1508116948
Name:BRIGHTER POSSIBILITIES SUPPORT SVCS
Entity Type:Organization
Organization Name:BRIGHTER POSSIBILITIES SUPPORT SVCS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MARCUS
Authorized Official - Last Name:CEASAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:762-241-3710
Mailing Address - Street 1:6006 BROADSTONE CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31907-9447
Mailing Address - Country:US
Mailing Address - Phone:762-241-3710
Mailing Address - Fax:
Practice Address - Street 1:6006 BROADSTONE CT
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31907-9447
Practice Address - Country:US
Practice Address - Phone:762-241-3710
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-13
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA110364305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization