Healthcare Provider Details

I. General information

NPI: 1942139621
Provider Name (Legal Business Name): BRIGHT HOPE RESIDENCE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

799 AVEBURY DR
PICKERINGTON OH
43147-7688
US

IV. Provider business mailing address

799 AVEBURY DR
PICKERINGTON OH
43147-7688
US

V. Phone/Fax

Practice location:
  • Phone: 603-660-1535
  • Fax:
Mailing address:
  • Phone: 603-660-1535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: TARA KHANAL
Title or Position: MANAGING MEMBER
Credential:
Phone: 603-660-1535