Healthcare Provider Details

I. General information

NPI: 1235053372
Provider Name (Legal Business Name): BRIGHT LIFE ABA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27202 PARK DR
ORANGE BEACH AL
36561-3952
US

IV. Provider business mailing address

27202 PARK DR
ORANGE BEACH AL
36561-3952
US

V. Phone/Fax

Practice location:
  • Phone: 251-744-4097
  • Fax:
Mailing address:
  • Phone: 251-744-4097
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: BETHANY BRAND
Title or Position: OWNER
Credential: BCBA, LBA, M.S.
Phone: 251-744-4097