Provider Demographics
NPI:1518743582
Name:BRIGHT BEHAVIORAL HEALTH CORP
Entity Type:Organization
Organization Name:BRIGHT BEHAVIORAL HEALTH CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAZ LLANES
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:786-569-6783
Mailing Address - Street 1:18001 OLD CUTLER RD STE 550
Mailing Address - Street 2:
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-6439
Mailing Address - Country:US
Mailing Address - Phone:786-569-6783
Mailing Address - Fax:
Practice Address - Street 1:18001 OLD CUTLER RD STE 550
Practice Address - Street 2:
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-6439
Practice Address - Country:US
Practice Address - Phone:786-569-6783
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-06
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty