Healthcare Provider Details

I. General information

NPI: 1578829479
Provider Name (Legal Business Name): BRIGHTON REHABILITATION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2012
Last Update Date: 04/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2670 PACIFIC HEIGHTS RD
HONOLULU HI
96813-1049
US

IV. Provider business mailing address

1952 E 7000 S 100
SALT LAKE CITY UT
84121-6877
US

V. Phone/Fax

Practice location:
  • Phone: 808-524-1955
  • Fax: 808-537-5418
Mailing address:
  • Phone: 801-942-3311
  • Fax: 801-942-5955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MELISSA GUSS-HOFFELMEYER
Title or Position: PRESIDENT
Credential:
Phone: 801-942-3311