Healthcare Provider Details

I. General information

NPI: 1730873555
Provider Name (Legal Business Name): BUILD BRIGHT CARE GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2023
Last Update Date: 06/05/2023
Certification Date: 06/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17169 LAHEY ST
GRANADA HILLS CA
91344-4140
US

IV. Provider business mailing address

451 N ORANGE DR
LOS ANGELES CA
90036-2611
US

V. Phone/Fax

Practice location:
  • Phone: 216-767-3438
  • Fax:
Mailing address:
  • Phone: 216-767-3438
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: AHRON LEFKOWITZ
Title or Position: CEO
Credential:
Phone: 216-767-3438