Provider Demographics
NPI:1902404742
Name:BRITE LIFE ADULT TRAINING PROGRAM, LLC
Entity Type:Organization
Organization Name:BRITE LIFE ADULT TRAINING PROGRAM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:ARICHE
Authorized Official - Suffix:
Authorized Official - Credentials:MASTERS DEGREE
Authorized Official - Phone:407-900-3124
Mailing Address - Street 1:20612 NW 12TH PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169-2435
Mailing Address - Country:US
Mailing Address - Phone:407-900-3124
Mailing Address - Fax:
Practice Address - Street 1:1300 NW 95TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33147-3320
Practice Address - Country:US
Practice Address - Phone:407-900-3124
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-14
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities