Provider Demographics
NPI:1750158267
Name:A BRIGHT FOUNDATION LLC
Entity type:Organization
Organization Name:A BRIGHT FOUNDATION LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAVIER
Authorized Official - Middle Name:
Authorized Official - Last Name:ENAMORADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:682-730-0670
Mailing Address - Street 1:1633 GREENRIDGE DR UNIT 7108
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-2983
Mailing Address - Country:US
Mailing Address - Phone:682-730-0670
Mailing Address - Fax:
Practice Address - Street 1:1633 GREENRIDGE DR UNIT 7108
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-2983
Practice Address - Country:US
Practice Address - Phone:682-730-0670
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-05
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health