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General NPI Number Information
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NPI Number | 1114637725
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Entity Type | Organization
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Legal Business Name | OMNI BRIGHT SOLUTIONS L. L. C
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Dates
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Enumeration Date | 12/05/2022
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Last Update Date | 12/05/2022
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Provider Practice Location Address
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Address Line | 18847 CARDONI ST
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City | HIGHLAND PARK
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State | MI
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Zip | 48203-2109
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Country | US
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Telephone | 313-742-8955
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Fax |
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Provider Business Mailing Address
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Address Line | 18847 CARDONI ST
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City | HIGHLAND PARK
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State | MI
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Zip | 48203-2109
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Country | US
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Telephone | 313-742-8955
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | SHONTAE RENE MORRIS
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Credential |
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Telephone | 313-742-8955
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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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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