Healthcare Provider Details

I. General information

NPI: 1245068824
Provider Name (Legal Business Name): BRIGHTER LIFE HOME HEALTH CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2024
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8983 WOOD DRIFT CIR APT 204
MANASSAS VA
20110-7600
US

IV. Provider business mailing address

8983 WOOD DRIFT CIR APT 204
MANASSAS VA
20110-7600
US

V. Phone/Fax

Practice location:
  • Phone: 571-277-2779
  • Fax:
Mailing address:
  • Phone: 571-277-2779
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. ELFECK SILLA JENG
Title or Position: OWNER
Credential: NURSE RN (BSN)
Phone: 571-277-2779