MEDICARE: BRIGHT BEGINNINGS1

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	163W00000X	Registered Nurse
2	251J00000X	Nursing Care Agency
3	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility
4	310500000X	Mental Illness Intermediate Care Facility

General Provider Information

NPI Number	:	1336958974
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIGHT BEGINNINGS1

Provider Business Mailing Address
First Line	:	811 E PONTIAC ST
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46803-3459
Country	:	US
Telephone Number	:	260-704-5466
Fax Number	:

Provider Business Practice Location Address
First Line	:	3120 BROADWAY
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46807-1509
Country	:	US
Telephone Number	:	260-704-5466
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KRONDA HUDDLESTON
Credential	:
Telephone Number	:	260-704-5466

Provider Enumeration Date	:	01/07/2025
Last Update Date	:	01/14/2025

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Directions to “BRIGHT BEGINNINGS1 ” Practice Location

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