Healthcare Provider Details

I. General information

NPI: 1114331618
Provider Name (Legal Business Name): BRIGHT STARZ LEARNING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2014
Last Update Date: 06/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6834 REFUGEE RD
CANAL WINCHESTER OH
43110-9368
US

IV. Provider business mailing address

230 BARNHILL CT
GAHANNA OH
43230-3704
US

V. Phone/Fax

Practice location:
  • Phone: 614-209-3533
  • Fax:
Mailing address:
  • Phone: 614-209-3533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code347B00000X
TaxonomyBus
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number400288
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code385HR2065X
TaxonomyChild Physical Disabilities Respite Care
License Number400288
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number400288
License Number StateOH
# 6
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL
# 7
Primary TaxonomyN
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number400288
License Number StateOH

VIII. Authorized Official

Name: LUCY WASHIKA
Title or Position: OWNER
Credential:
Phone: 614-209-3533