Healthcare Provider Details

I. General information

NPI: 1902584790
Provider Name (Legal Business Name): BRIGHT BEGINNINGS BABY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2023
Last Update Date: 07/11/2023
Certification Date: 07/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

152 W 2ND ST
DELPHOS OH
45833-1601
US

IV. Provider business mailing address

152 W 2ND ST
DELPHOS OH
45833-1601
US

V. Phone/Fax

Practice location:
  • Phone: 567-765-1111
  • Fax: 567-765-1110
Mailing address:
  • Phone: 567-765-1111
  • Fax: 567-765-1110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: THRESA LYNN GROTHAUS
Title or Position: OWNER
Credential: APRN, CPNP-PC
Phone: 567-765-1111