Healthcare Provider Details

I. General information

NPI: 1417275157
Provider Name (Legal Business Name): BRIGHT HORIZONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2010
Last Update Date: 05/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

GHIYEGHI ST. SAN JOSE
SAIPAN MP
96950-3287
US

IV. Provider business mailing address

PO BOX 503287 GHIYEGHI ST. SAN JOSE
SAIPAN MP
96950-3287
US

V. Phone/Fax

Practice location:
  • Phone: 670-483-8890
  • Fax: 670-235-4655
Mailing address:
  • Phone: 670-483-8890
  • Fax: 670-235-4655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number19359-0002-1
License Number StateMP

VIII. Authorized Official

Name: MRS. SUSAN TEJADA DEBLOIS
Title or Position: MANAGING DIRECTOR
Credential: RN
Phone: 670-483-8890