Provider Demographics
NPI:1760021836
Name:A BRIGHTSTART SERVICES INC
Entity Type:Organization
Organization Name:A BRIGHTSTART SERVICES INC
Other - Org Name:BRIGHTSTAR HOME HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LOLIN
Authorized Official - Middle Name:NYOKABI
Authorized Official - Last Name:STEVENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-933-9185
Mailing Address - Street 1:2903 ALYSON WAY
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-0429
Mailing Address - Country:US
Mailing Address - Phone:817-933-9185
Mailing Address - Fax:817-417-0503
Practice Address - Street 1:2903 ALYSON WAY
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-0429
Practice Address - Country:US
Practice Address - Phone:817-933-9185
Practice Address - Fax:817-417-0503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-06
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes385H00000XRespite Care FacilityRespite CareGroup - Multi-Specialty
No251E00000XAgenciesHome HealthGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1760021836Medicaid