Healthcare Provider Details
I. General information
NPI: 1093337073
Provider Name (Legal Business Name): BRIGHTER DAYS TREATMENT CENTERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/12/2020
Last Update Date: 03/14/2022
Certification Date: 03/14/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3201 ARMAND ST
MONROE LA
71201-3915
US
IV. Provider business mailing address
2509 BROADMOOR BLVD STE B
MONROE LA
71201-3184
US
V. Phone/Fax
- Phone: 318-737-1095
- Fax:
- Phone: 318-737-1095
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QA0505X |
| Taxonomy | Adult Medicine Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ASHLEY
HENDRIX
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 318-789-7239