Provider Demographics
NPI:1396592663
Name:BRIGHT PATH, INC.
Entity type:Organization
Organization Name:BRIGHT PATH, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:M
Authorized Official - Last Name:EMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:CRM, CADC-R
Authorized Official - Phone:541-246-5902
Mailing Address - Street 1:PO BOX 1867
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:OR
Mailing Address - Zip Code:97801-0930
Mailing Address - Country:US
Mailing Address - Phone:541-862-4357
Mailing Address - Fax:
Practice Address - Street 1:39 SE COURT AVE STE 202
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:OR
Practice Address - Zip Code:97801-2228
Practice Address - Country:US
Practice Address - Phone:541-862-4357
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-03
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No175T00000XOther Service ProvidersPeer SpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR1497410856Medicaid
14675052OtherCAQH PROVIDER
OR1962183293Medicaid
IN1194349472Medicaid