Healthcare Provider Details

I. General information

NPI: 1285197251
Provider Name (Legal Business Name): SHANTELL WALKINE DBA BRIGHTER CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2019
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1860 SW FOUNTAINVIEW BLVD STE 74
PORT ST LUCIE FL
34986-4535
US

IV. Provider business mailing address

1860 SW FOUNTAINVIEW BLVD STE 74
PORT ST LUCIE FL
34986-4535
US

V. Phone/Fax

Practice location:
  • Phone: 772-200-3771
  • Fax: 772-302-3807
Mailing address:
  • Phone: 772-200-3771
  • Fax: 772-302-3807

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: SHANTELL WALKINE
Title or Position: OWNER
Credential:
Phone: 772-828-3045