Healthcare Provider Details

I. General information

NPI: 1457104747
Provider Name (Legal Business Name): BRIGHTEN ABILITIES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2024
Last Update Date: 06/21/2024
Certification Date: 06/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5902 SHERMAN LAKES WAY
GALENA OH
43021-8064
US

IV. Provider business mailing address

5902 SHERMAN LAKES WAY
GALENA OH
43021-8064
US

V. Phone/Fax

Practice location:
  • Phone: 248-990-4545
  • Fax:
Mailing address:
  • Phone: 248-990-4545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARIAM SALEEM
Title or Position: DOO
Credential:
Phone: 248-990-4545