Healthcare Provider Details

I. General information

NPI: 1073614392
Provider Name (Legal Business Name): BRIGHTPATH ADULT DAY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

577 WALNUT ST
ELKO NV
89801-2501
US

IV. Provider business mailing address

PO BOX 279
ELKO NV
89803-0279
US

V. Phone/Fax

Practice location:
  • Phone: 775-778-0547
  • Fax: 775-738-0541
Mailing address:
  • Phone: 775-778-0547
  • Fax: 775-738-0541

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number3681ADC-6
License Number StateNV

VIII. Authorized Official

Name: SYLVIA ELEXPURU
Title or Position: EXECUTIVE DIRECTOR
Credential: R.N.
Phone: 775-778-0547