Healthcare Provider Details

I. General information

NPI: 1609696723
Provider Name (Legal Business Name): BRIGHTER FUTURE HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2024
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 PINNACLE CT
RAEFORD NC
28376-4411
US

IV. Provider business mailing address

305 PINNACLE CT
RAEFORD NC
28376-4411
US

V. Phone/Fax

Practice location:
  • Phone: 910-823-6537
  • Fax:
Mailing address:
  • Phone: 910-823-6537
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: JARVIS COBB
Title or Position: CEO
Credential:
Phone: 910-823-6537