Provider Demographics
NPI:1881012409
Name:BRIGHTER DIMENSIONS, LLC
Entity Type:Organization
Organization Name:BRIGHTER DIMENSIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:R
Authorized Official - Last Name:CORDLE
Authorized Official - Suffix:JR
Authorized Official - Credentials:MA
Authorized Official - Phone:918-850-6503
Mailing Address - Street 1:514 W ATLANTA ST
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-7004
Mailing Address - Country:US
Mailing Address - Phone:918-280-9104
Mailing Address - Fax:918-609-2850
Practice Address - Street 1:514 W ATLANTA ST
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-7004
Practice Address - Country:US
Practice Address - Phone:918-280-9104
Practice Address - Fax:918-609-2850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-01
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty