Provider Demographics
NPI:1649856089
Name:BRIGHT MENTAL THERAPY LLC
Entity type:Organization
Organization Name:BRIGHT MENTAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KLEMNYS
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-928-0333
Mailing Address - Street 1:15600 SW 288TH ST STE 407
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-1243
Mailing Address - Country:US
Mailing Address - Phone:786-674-2256
Mailing Address - Fax:
Practice Address - Street 1:15600 SW 288TH ST STE 407
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-1243
Practice Address - Country:US
Practice Address - Phone:786-674-2256
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-23
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center