Provider Demographics
NPI:1013493048
Name:BRIGHT FUTURE COMMUNITY HEALTH CARE SERVICES
Entity Type:Organization
Organization Name:BRIGHT FUTURE COMMUNITY HEALTH CARE SERVICES
Other - Org Name:BRIGHT FUTURE COMMUNITY HEALTH CARE SERVICES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:EMMANUELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:OWOBU
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:443-912-4612
Mailing Address - Street 1:907 FOXWOOD LN
Mailing Address - Street 2:
Mailing Address - City:ESSEX
Mailing Address - State:MD
Mailing Address - Zip Code:21221-5929
Mailing Address - Country:US
Mailing Address - Phone:443-912-4612
Mailing Address - Fax:
Practice Address - Street 1:403 EASTERN BLVD
Practice Address - Street 2:
Practice Address - City:ESSEX
Practice Address - State:MD
Practice Address - Zip Code:21221-6715
Practice Address - Country:US
Practice Address - Phone:443-912-4612
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BRIGHT FUTURE COMMUNITY HEALTH CARE SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-07-12
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDBH000992101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDBH000992OtherBEHAVIORAL HEALTH ADMINISTRATION