MEDICARE: BRIGHTON HEART HEALING CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1306456975
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIGHTON HEART HEALING CENTER LLC

Provider Business Mailing Address
First Line	:	9102 CAPISTRANO ST S UNIT 7208
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34113-3241
Country	:	US
Telephone Number	:	239-276-9030
Fax Number	:

Provider Business Practice Location Address
First Line	:	405 FIFTH AVE S STE 7
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34102-6515
Country	:	US
Telephone Number	:	239-276-9030
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	NANCY BRIGHTON
Credential	:
Telephone Number	:	609-644-3291

Provider Enumeration Date	:	08/07/2020
Last Update Date	:	08/07/2020

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Directions to “BRIGHTON HEART HEALING CENTER LLC ” Practice Location

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