Provider Demographics
NPI:1871463935
Name:BRIGHTSIDE HOME CARE LLC
Entity type:Organization
Organization Name:BRIGHTSIDE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:INTISAR
Authorized Official - Middle Name:MOHAMED
Authorized Official - Last Name:WARSAME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-703-2222
Mailing Address - Street 1:19281 DUNBURY AVE
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55024-8747
Mailing Address - Country:US
Mailing Address - Phone:612-703-2222
Mailing Address - Fax:
Practice Address - Street 1:19281 DUNBURY AVE
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55024-8747
Practice Address - Country:US
Practice Address - Phone:612-703-2222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-05
Last Update Date:2025-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty