Provider Demographics
NPI:1821696162
Name:BRIGHT LAND INC
Entity Type:Organization
Organization Name:BRIGHT LAND INC
Other - Org Name:BRIGHT LAND BEHAVIORAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NELSON
Authorized Official - Middle Name:
Authorized Official - Last Name:PRADO CANTO
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:305-491-3494
Mailing Address - Street 1:3507 LEE BLVD STE 212
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33971-1303
Mailing Address - Country:US
Mailing Address - Phone:239-888-0561
Mailing Address - Fax:239-360-8924
Practice Address - Street 1:3507 LEE BLVD STE 212
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33971-1303
Practice Address - Country:US
Practice Address - Phone:239-888-0561
Practice Address - Fax:239-360-8924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-09
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty