Provider Demographics
NPI:1295188068
Name:BRIGHT EYES FAMILY SERVICES, LLC
Entity type:Organization
Organization Name:BRIGHT EYES FAMILY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:FALON
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WILKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:BHCM II
Authorized Official - Phone:405-810-5554
Mailing Address - Street 1:4334 NW EXPRESSWAY
Mailing Address - Street 2:SUITE 211
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73116-1578
Mailing Address - Country:US
Mailing Address - Phone:405-810-5554
Mailing Address - Fax:855-313-3884
Practice Address - Street 1:4334 NW EXPRESSWAY
Practice Address - Street 2:SUITE 211
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-1578
Practice Address - Country:US
Practice Address - Phone:405-810-5554
Practice Address - Fax:855-313-3884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-18
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health