Provider Demographics
NPI:1013380427
Name:BRIGHTON FAMILY CENTER, PLC
Entity Type:Organization
Organization Name:BRIGHTON FAMILY CENTER, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:WARWICK
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:ARMSTRONG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:810-229-0844
Mailing Address - Street 1:10856 MI STATE ROAD 52
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48158-9412
Mailing Address - Country:US
Mailing Address - Phone:810-229-0844
Mailing Address - Fax:734-428-0960
Practice Address - Street 1:10315 GRAND RIVER RD
Practice Address - Street 2:SUITE 104
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-9594
Practice Address - Country:US
Practice Address - Phone:810-229-0844
Practice Address - Fax:734-428-0960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-06
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401012196101YP2500X
MI6301002961103TB0200X
MI4101005450103TF0000X
MI4101006471106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamilyGroup - Single Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIMI1500Medicare PIN