Provider Demographics
NPI:1811441033
Name:A BRIGHTER DAY HOME CARE, INC.
Entity type:Organization
Organization Name:A BRIGHTER DAY HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:REGINA
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-502-9012
Mailing Address - Street 1:3822 BEECH DOWN DR
Mailing Address - Street 2:
Mailing Address - City:CHANTILLY
Mailing Address - State:VA
Mailing Address - Zip Code:20151-3349
Mailing Address - Country:US
Mailing Address - Phone:571-221-5748
Mailing Address - Fax:703-563-6065
Practice Address - Street 1:10617 JONES ST
Practice Address - Street 2:301-A
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-7506
Practice Address - Country:US
Practice Address - Phone:703-502-9012
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:A BRIGHTER DAY HOME CARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-08-04
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YA0400X, 101YP2500X, 1041C0700X, 163W00000X, 207R00000X, 2084P0800X, 253Z00000X
VAHCO-171315253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0231517076Medicaid