Healthcare Provider Details

I. General information

NPI: 1740113091
Provider Name (Legal Business Name): EVERGREEN BRIGHT PATH HORIZONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1508 W JEFFERSON AVE UNIT D
NAPERVILLE IL
60540-5066
US

IV. Provider business mailing address

PO BOX 10
WARRENVILLE IL
60555-0010
US

V. Phone/Fax

Practice location:
  • Phone: 630-870-6453
  • Fax:
Mailing address:
  • Phone: 630-870-6453
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: ERIKA WADE
Title or Position: FOUNDER & PRESIDENT
Credential:
Phone: 630-870-6453