Healthcare Provider Details

I. General information

NPI: 1336054097
Provider Name (Legal Business Name): BRIGHTWELL CARE SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4136 MEADOW HILL LN
FAIRFAX VA
22033-3112
US

IV. Provider business mailing address

4095 OAK VILLAGE LDG
FAIRFAX VA
22033-6228
US

V. Phone/Fax

Practice location:
  • Phone: 305-803-0575
  • Fax: 703-763-5707
Mailing address:
  • Phone: 305-803-0575
  • Fax: 703-763-5707

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. ALEX PEREZ
Title or Position: MANAGING MEMBER
Credential:
Phone: 305-803-0575