Healthcare Provider Details

I. General information

NPI: 1356272587
Provider Name (Legal Business Name): BRIGHT ABA CARE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1411 COLLEGIATE CIRRALEIGH, NC 303 APART
RALEIGH NC
27606
US

IV. Provider business mailing address

1411 COLLEGIATE CIRRALEIGH, NC 303 APART
RALEIGH NC
27606
US

V. Phone/Fax

Practice location:
  • Phone: 845-464-2798
  • Fax:
Mailing address:
  • Phone: 845-464-2798
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: MR. MAHMOUD IBRAHIM ALI SHEHATA SR.
Title or Position: FOUNDER-CLINICAL DIRECTOR
Credential: MS , BCBA , LBA
Phone: 845-464-2798