Provider Demographics
NPI:1821793977
Name:BRIGHT MISSION RECOVERY
Entity Type:Organization
Organization Name:BRIGHT MISSION RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:KALADJIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-331-3531
Mailing Address - Street 1:2410 N KEYSTONE ST
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91504-2711
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:35400 VIA FAMERO DR
Practice Address - Street 2:
Practice Address - City:ACTON
Practice Address - State:CA
Practice Address - Zip Code:93510-2323
Practice Address - Country:US
Practice Address - Phone:747-444-3284
Practice Address - Fax:747-444-3285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-30
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility