Healthcare Provider Details

I. General information

NPI: 1942658505
Provider Name (Legal Business Name): BRIGHTER HORIZONS ADULT DAY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2016
Last Update Date: 05/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 1/2 NW 8TH ST
BRAINERD MN
56401-3212
US

IV. Provider business mailing address

307 1/2 NW 8TH ST
BRAINERD MN
56401-3212
US

V. Phone/Fax

Practice location:
  • Phone: 218-829-0636
  • Fax: 218-829-0068
Mailing address:
  • Phone: 218-829-0636
  • Fax: 218-829-0068

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number1077546-1-ADC
License Number StateMN

VIII. Authorized Official

Name: AMY L BAUER NELSON
Title or Position: PROGRAM DIRECTOR
Credential:
Phone: 218-232-0541