Provider Demographics
NPI:1508357419
Name:BRIGHTSIDE BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:BRIGHTSIDE BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BARMAK
Authorized Official - Middle Name:
Authorized Official - Last Name:HEFAZI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-307-9212
Mailing Address - Street 1:3972 BARRANCA PKWY STE J458
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92606-1204
Mailing Address - Country:US
Mailing Address - Phone:949-307-9212
Mailing Address - Fax:
Practice Address - Street 1:16168 BEACH BLVD STE 100
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-3872
Practice Address - Country:US
Practice Address - Phone:949-307-9212
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-25
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility