MEDICARE: BRIGHT ROSE GROUP HOME SERVICES INC

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1770229296
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIGHT ROSE GROUP HOME SERVICES INC

Provider Business Mailing Address
First Line	:	4576 ASHMORE CIR NE
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30066-1617
Country	:	US
Telephone Number	:	678-906-1987
Fax Number	:

Provider Business Practice Location Address
First Line	:	4576 ASHMORE CIR NE
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30066-1617
Country	:	US
Telephone Number	:	678-906-1987
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	OMOLOLA COLE
Credential	:
Telephone Number	:	678-906-1987

Provider Enumeration Date	:	05/08/2022
Last Update Date	:	05/08/2022

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