Healthcare Provider Details

I. General information

NPI: 1073788378
Provider Name (Legal Business Name): BRIGHT EXPECTATIONS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2008
Last Update Date: 04/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5593 AVENUE JUAN BAUTISTA
RIVERSIDE CA
92509-5614
US

IV. Provider business mailing address

8175 LIMONITE AVE SUITE C
RIVERSIDE CA
92509-6120
US

V. Phone/Fax

Practice location:
  • Phone: 951-727-4303
  • Fax: 951-727-4304
Mailing address:
  • Phone: 951-727-4303
  • Fax: 951-727-4304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MISS HENRY CHARLES COX III
Title or Position: PRESIDENT / ADMINISTRATOR
Credential:
Phone: 951-727-4303