Provider Demographics
NPI:1245008762
Name:BRIGHT KIDZ LLC
Entity type:Organization
Organization Name:BRIGHT KIDZ LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ALINA
Authorized Official - Middle Name:
Authorized Official - Last Name:VITALI
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LMHC
Authorized Official - Phone:800-961-3367
Mailing Address - Street 1:3201 TAMIAMI TRL N STE 128
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-4135
Mailing Address - Country:US
Mailing Address - Phone:800-961-3367
Mailing Address - Fax:800-961-3367
Practice Address - Street 1:3201 TAMIAMI TRL N STE 128
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-4135
Practice Address - Country:US
Practice Address - Phone:800-961-3367
Practice Address - Fax:800-961-3367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-14
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty