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General NPI Number Information
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NPI Number | 1083206122
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Entity Type | Organization
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Legal Business Name | BRIGHT LIVING LEWISVILLE, LLC
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Dates
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Enumeration Date | 02/10/2021
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Last Update Date | 02/10/2021
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Provider Practice Location Address
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Address Line | 400 HIGHLAND DR
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City | LEWISVILLE
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State | TX
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Zip | 75067-3871
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Country | US
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Telephone | 972-315-1532
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Fax |
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Provider Business Mailing Address
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Address Line | 302 CROSS ST
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City | NEW BRAUNFELS
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State | TX
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Zip | 78130-5644
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Country | US
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Telephone | 830-730-4472
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Fax |
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Authorized Official
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Title or Position | CFO/MGR
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Name | TRAVIS WOMMACK
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Credential |
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Telephone | 830-730-4470
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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