Provider Demographics
NPI:1710550512
Name:BRIGHTVIEW LLC
Entity Type:Organization
Organization Name:BRIGHTVIEW LLC
Other - Org Name:BRIGHTVIEW
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-834-7063
Mailing Address - Street 1:615 ELSINORE PL STE 200
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45202-1457
Mailing Address - Country:US
Mailing Address - Phone:513-834-7063
Mailing Address - Fax:513-873-1567
Practice Address - Street 1:621 HAPPY VALLEY RD
Practice Address - Street 2:
Practice Address - City:GLASGOW
Practice Address - State:KY
Practice Address - Zip Code:42141-1541
Practice Address - Country:US
Practice Address - Phone:513-834-7063
Practice Address - Fax:513-873-1567
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BRIGHTVIEW LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-07-20
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction MedicineGroup - Multi-Specialty
No261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadoneGroup - Multi-Specialty