Healthcare Provider Details

I. General information

NPI: 1881311405
Provider Name (Legal Business Name): BRIGHTNOON HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2022
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 CUMMINGS CTR STE 347-C
BEVERLY MA
01915-6115
US

IV. Provider business mailing address

100 CUMMINGS CTR STE 347-C
BEVERLY MA
01915-6115
US

V. Phone/Fax

Practice location:
  • Phone: 978-871-0693
  • Fax:
Mailing address:
  • Phone: 978-907-0458
  • Fax: 978-998-4751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: DORLINE LAURE NONO EPSE NGUEJIP
Title or Position: CEO
Credential: LPN
Phone: 978-907-0458