Healthcare Provider Details

I. General information

NPI: 1457116089
Provider Name (Legal Business Name): BRIGHTER NE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2024
Last Update Date: 02/13/2024
Certification Date: 02/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2111 S 67TH ST STE 300
OMAHA NE
68106-2882
US

IV. Provider business mailing address

3600 ROUTE 66 STE 150
NEPTUNE NJ
07753-2645
US

V. Phone/Fax

Practice location:
  • Phone: 410-609-6357
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: ABE WOLMARK
Title or Position: OWNER
Credential:
Phone: 410-609-6357