MEDICARE: BRIGHT HORIZONS, 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	251E00000X	Home Health Agency	19359-0002-1	MP

General Provider Information

NPI Number	:	1417275157
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIGHT HORIZONS, LLC

Provider Business Mailing Address
First Line	:	PO BOX 503287
Second Line	:	GHIYEGHI ST. SAN JOSE
City	:	SAIPAN
State	:	MP
Zip	:	96950-3287
Country	:	US
Telephone Number	:	670-483-8890
Fax Number	:	670-235-4655

Provider Business Practice Location Address
First Line	:	GHIYEGHI ST. SAN JOSE
Second Line	:
City	:	SAIPAN
State	:	MP
Zip	:	96950-3287
Country	:	US
Telephone Number	:	670-483-8890
Fax Number	:	670-235-4655

Authorized Official
Title or Position	:	MANAGING DIRECTOR
Name	:	MRS. SUSAN TEJADA DEBLOIS
Credential	:	RN
Telephone Number	:	670-483-8890

Provider Enumeration Date	:	05/05/2010
Last Update Date	:	05/05/2010

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