Provider Demographics
NPI:1255029518
Name:BLUE HORIZONS GROUP HOMES LLC
Entity type:Organization
Organization Name:BLUE HORIZONS GROUP HOMES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANAE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAHAM BRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:757-920-9120
Mailing Address - Street 1:4317 BONNEY RD # 4
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-1235
Mailing Address - Country:US
Mailing Address - Phone:757-920-9120
Mailing Address - Fax:
Practice Address - Street 1:4317 BONNEY RD # 4
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-1235
Practice Address - Country:US
Practice Address - Phone:757-920-9120
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-25
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities