Provider Demographics
NPI:1679656037
Name:BRIGHT START OCCUPATIONAL THERAPY, LLC
Entity Type:Organization
Organization Name:BRIGHT START OCCUPATIONAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:INSON
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:303-596-3785
Mailing Address - Street 1:479 SHOREHAM CIR
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80108-9050
Mailing Address - Country:US
Mailing Address - Phone:303-596-3785
Mailing Address - Fax:
Practice Address - Street 1:479 SHOREHAM CIR
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80108-9050
Practice Address - Country:US
Practice Address - Phone:303-596-3785
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO59722321Medicaid