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General NPI Number Information
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NPI Number | 1053027722
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Entity Type | Organization
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Legal Business Name | BRIGHT HORIZON COMMUNITY INC
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Dates
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Enumeration Date | 01/26/2023
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Last Update Date | 03/27/2023
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Provider Practice Location Address
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Address Line | 20720 NW 1ST CT
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City | MIAMI GARDENS
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State | FL
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Zip | 33169-2248
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Country | US
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Telephone | 305-525-9195
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Fax |
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Provider Business Mailing Address
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Address Line | 1150 NW 184TH DR
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City | MIAMI GARDENS
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State | FL
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Zip | 33169-4272
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/DIRECTOR/OWNER
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Name | MR. DEMETRIUS RAPHAEL
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Credential |
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Telephone | 305-525-9195
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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