Provider Demographics
NPI:1205615655
Name:BRIGHTLIFE PSYCH SERVICES LLC
Entity type:Organization
Organization Name:BRIGHTLIFE PSYCH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUJANA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAYANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:740-710-3100
Mailing Address - Street 1:700 BRYDEN RD STE 124
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-4839
Mailing Address - Country:US
Mailing Address - Phone:614-681-0012
Mailing Address - Fax:
Practice Address - Street 1:700 BRYDEN RD STE 124
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-4839
Practice Address - Country:US
Practice Address - Phone:614-681-0012
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty