Provider Demographics
NPI:1649665506
Name:BRIGHTERSIDE HOME CARE
Entity type:Organization
Organization Name:BRIGHTERSIDE HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHANNA
Authorized Official - Middle Name:MONA
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-922-9038
Mailing Address - Street 1:295 INDUSTRIAL DR
Mailing Address - Street 2:SUITE D
Mailing Address - City:CHRISTIANSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24073-2538
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:295 INDUSTRIAL DR
Practice Address - Street 2:SUITE D
Practice Address - City:CHRISTIANSBURG
Practice Address - State:VA
Practice Address - Zip Code:24073-2538
Practice Address - Country:US
Practice Address - Phone:540-922-9038
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-30
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA253Z00000X253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care