Healthcare Provider Details
I. General information
NPI: 1255145165
Provider Name (Legal Business Name): BRIGHT PATH CARE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/03/2025
Last Update Date: 02/03/2025
Certification Date: 02/03/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8735 DUNWOODY PL # 6828
ATLANTA GA
30350-2995
US
IV. Provider business mailing address
8735 DUNWOODY PL # 6828
ATLANTA GA
30350-2995
US
V. Phone/Fax
- Phone: 470-852-9602
- Fax:
- Phone: 470-852-9602
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 343900000X |
| Taxonomy | Non-emergency Medical Transport (VAN) |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 385H00000X |
| Taxonomy | Respite Care |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TAYLOR
BRADLEY
Title or Position: CFO
Credential:
Phone: 470-852-9602