Provider Demographics
NPI:1710586144
Name:BRIGHTER TOMORROW'S FAMILY SERVICES, LLC
Entity Type:Organization
Organization Name:BRIGHTER TOMORROW'S FAMILY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:DERRISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAGGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-808-5777
Mailing Address - Street 1:644 N COUNTRY CLUB DR STE D
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85201-4983
Mailing Address - Country:US
Mailing Address - Phone:702-210-5865
Mailing Address - Fax:
Practice Address - Street 1:644 N COUNTRY CLUB DR STE D
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85201-4983
Practice Address - Country:US
Practice Address - Phone:702-210-5865
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-16
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZOOOOOOOOMedicaid