Healthcare Provider Details

I. General information

NPI: 1497686737
Provider Name (Legal Business Name): BRIGHT PATH HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

629 W JARDIN DR
CASA GRANDE AZ
85122-5117
US

IV. Provider business mailing address

629 W JARDIN DR
CASA GRANDE AZ
85122-5117
US

V. Phone/Fax

Practice location:
  • Phone: 480-235-8942
  • Fax:
Mailing address:
  • Phone: 480-235-8942
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: CHARLES AJASSI
Title or Position: CEO
Credential:
Phone: 480-235-8942