Provider Demographics
NPI:1922464510
Name:BRIGHTER FAMILIES LLC
Entity Type:Organization
Organization Name:BRIGHTER FAMILIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:EVONNE
Authorized Official - Last Name:BOUC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-910-8453
Mailing Address - Street 1:812 S VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62220-3689
Mailing Address - Country:US
Mailing Address - Phone:618-236-2482
Mailing Address - Fax:
Practice Address - Street 1:812 S VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62220-3689
Practice Address - Country:US
Practice Address - Phone:618-236-2482
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-12
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency