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General NPI Number Information
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NPI Number | 1023289436
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Entity Type | Organization
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Legal Business Name | BRIGHT BEGINNINGS PDC INC.
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Dates
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Enumeration Date | 03/13/2008
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Last Update Date | 06/29/2010
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Provider Practice Location Address
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Address Line | 586 WILLIAM LATHAM DR SUITE 6A
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City | BOURBONNAIS
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State | IL
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Zip | 60914-2327
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Country | US
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Telephone | 815-932-0381
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Fax | 815-932-0381
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Provider Business Mailing Address
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Address Line | 40 E JOLIET ST SUITE A
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City | SCHERERVILLE
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State | IN
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Zip | 46375-2054
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Country | US
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Telephone | 219-979-2735
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Fax | 219-865-1311
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Authorized Official
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Title or Position | OWNER/OCCUPATIONAL THERAPIST
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Name | MRS. AMANDA JOANNE KEMNETZ
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Credential | OTR/L
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Telephone | 815-932-0381
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number | 056-006344
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License Number State | IL
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