Provider Demographics
NPI:1841753035
Name:BRITE BRIDGES OF THE TREASURE COAST, INC.
Entity Type:Organization
Organization Name:BRITE BRIDGES OF THE TREASURE COAST, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ROSALYN
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-480-4556
Mailing Address - Street 1:1025 10TH CT SW
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32962-5424
Mailing Address - Country:US
Mailing Address - Phone:772-480-4556
Mailing Address - Fax:
Practice Address - Street 1:8003 PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34951-2716
Practice Address - Country:US
Practice Address - Phone:772-480-4556
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-13
Last Update Date:2019-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health