Healthcare Provider Details

I. General information

NPI: 1992161046
Provider Name (Legal Business Name): BRIGHT FUTURES WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2016
Last Update Date: 02/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2320 S SEACREST BLVD SUITE 202
BOYNTON BEACH FL
33435-6517
US

IV. Provider business mailing address

2320 S SEACREST BLVD SUITE 202
BOYNTON BEACH FL
33435-6517
US

V. Phone/Fax

Practice location:
  • Phone: 561-441-4279
  • Fax:
Mailing address:
  • Phone: 561-441-4279
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. ALVISE PUGLIESE
Title or Position: CEO
Credential:
Phone: 561-441-4279