Healthcare Provider Details

I. General information

NPI: 1356021299
Provider Name (Legal Business Name): BRIGHTER DAYS MHC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2023
Last Update Date: 07/27/2023
Certification Date: 07/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

657 W 19TH ST
COSTA MESA CA
92627-8600
US

IV. Provider business mailing address

657 W 19TH ST
COSTA MESA CA
92627-8600
US

V. Phone/Fax

Practice location:
  • Phone: 657-651-9359
  • Fax:
Mailing address:
  • Phone: 657-651-9359
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JISUNG YOON
Title or Position: DOCTOR
Credential: MD
Phone: 909-485-7974