Provider Demographics
NPI:1720363336
Name:WESTERN DEVELOPMENT, INC.
Entity Type:Organization
Organization Name:WESTERN DEVELOPMENT, INC.
Other - Org Name:BRIGHTSTAR HIGH DESERT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESDIENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:B
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-810-4080
Mailing Address - Street 1:17995 US HIGHWAY 18
Mailing Address - Street 2:SUITE 1
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-2190
Mailing Address - Country:US
Mailing Address - Phone:760-810-4080
Mailing Address - Fax:760-810-4036
Practice Address - Street 1:17995 US HIGHWAY 18
Practice Address - Street 2:SUITE 1
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-2190
Practice Address - Country:US
Practice Address - Phone:760-810-4080
Practice Address - Fax:760-810-4036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-14
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health