Provider Demographics
NPI:1356462543
Name:BRIGHTER HORIZONS BEHAVIORAL HEALTH
Entity type:Organization
Organization Name:BRIGHTER HORIZONS BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRKWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-453-5806
Mailing Address - Street 1:23062 JERICHO RD
Mailing Address - Street 2:
Mailing Address - City:EDINBORO
Mailing Address - State:PA
Mailing Address - Zip Code:16412-5148
Mailing Address - Country:US
Mailing Address - Phone:814-398-1805
Mailing Address - Fax:
Practice Address - Street 1:23062 JERICHO RD
Practice Address - Street 2:
Practice Address - City:EDINBORO
Practice Address - State:PA
Practice Address - Zip Code:16412-5148
Practice Address - Country:US
Practice Address - Phone:814-398-1805
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018006350001Medicaid