Healthcare Provider Details

I. General information

NPI: 1639623937
Provider Name (Legal Business Name): BRIGHTER DAY HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2016
Last Update Date: 08/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10741 BARNSFORD LN
HELOTES TX
78023-4696
US

IV. Provider business mailing address

455 N DAKOTA AVE
CORSICA SD
57328-2110
US

V. Phone/Fax

Practice location:
  • Phone: 832-742-0117
  • Fax:
Mailing address:
  • Phone: 832-742-0117
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JUNE W MAXFELDT
Title or Position: SENIOR VICE PRESIDENT OF OPERATIONS
Credential:
Phone: 713-554-0830