Healthcare Provider Details

I. General information

NPI: 1518692763
Provider Name (Legal Business Name): BRIGHTER DAY ADULT SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2022
Last Update Date: 01/30/2023
Certification Date: 01/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1716 POCOSHOCK BLVD
NORTH CHESTERFIELD VA
23235-5612
US

IV. Provider business mailing address

3021 CHISLET DR
MIDLOTHIAN VA
23112-3403
US

V. Phone/Fax

Practice location:
  • Phone: 804-658-5377
  • Fax: 833-838-9829
Mailing address:
  • Phone: 804-625-5746
  • Fax: 833-838-9829

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: DEMETRIUS SPRUILL
Title or Position: MEMBER
Credential:
Phone: 804-625-5746