Provider Demographics
NPI:1851977904
Name:BRIGHT KIDS BEHAVIOR INC
Entity Type:Organization
Organization Name:BRIGHT KIDS BEHAVIOR INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:YANISLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MORALES VALDIVIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-461-9978
Mailing Address - Street 1:1660 SOUTHERN BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-3219
Mailing Address - Country:US
Mailing Address - Phone:561-653-1245
Mailing Address - Fax:
Practice Address - Street 1:1660 SOUTHERN BLVD STE C
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-3219
Practice Address - Country:US
Practice Address - Phone:561-653-1245
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-19
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL110052900Medicaid