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NPI Code Detail

MEDICARE: BRIGHT BEHAVIOR INC

MEDICARE: BRIGHT BEHAVIOR 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
1103T00000XPsychologist
2225100000XPhysical Therapist
3225X00000XOccupational Therapist
4235Z00000XSpeech-Language Pathologist
5103K00000XBehavior Analyst

General Provider Information

NPI Number : 1841712809
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRIGHT BEHAVIOR INC
Provider Business Mailing Address
First Line : 104 W OLD BROADMOOR RD
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80906-3336
Country : US
Telephone Number : 214-901-4196
Fax Number :
Provider Business Practice Location Address
First Line : 4815 LIST DR STE 107
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80919-3340
Country : US
Telephone Number : 214-901-4196
Fax Number :
Authorized Official
Title or Position : OPERATIONS DIRECTOR
Name : RUSS MCGUIRE
Credential :
Telephone Number : 719-325-6311
Provider Enumeration Date : 07/12/2017
Last Update Date : 01/26/2023

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Directions to “BRIGHT BEHAVIOR INC ” Practice Location

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