Provider Demographics
NPI:1942659453
Name:BRIGHT FUTURES SUPPORT
Entity Type:Organization
Organization Name:BRIGHT FUTURES SUPPORT
Other - Org Name:SERVICES INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:YAZNELLY
Authorized Official - Middle Name:S
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:MSPA, MSCJ, BS
Authorized Official - Phone:407-508-7374
Mailing Address - Street 1:5747 CROWNTREE LN APT 111
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32829
Mailing Address - Country:US
Mailing Address - Phone:407-286-4796
Mailing Address - Fax:
Practice Address - Street 1:2180 CENTRAL FLORIDA PKWY STE A2
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-8900
Practice Address - Country:US
Practice Address - Phone:407-286-4796
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-06
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty