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General NPI Number Information
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NPI Number | 1124938147
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Entity Type | Organization
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Legal Business Name | BRIGHT LIFE DETOX & RECOVERY
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Dates
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Enumeration Date | 09/10/2026
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Last Update Date | 09/10/2026
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Provider Practice Location Address
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Address Line | 3164 ELMORE ST
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City | SIMI VALLEY
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State | CA
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Zip | 93063-2620
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Country | US
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Telephone | 805-261-0339
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Fax | 805-261-0130
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Provider Business Mailing Address
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Address Line | 3164 ELMORE ST
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City | SIMI VALLEY
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State | CA
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Zip | 93063-2620
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Country | US
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Telephone | 805-261-0339
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Fax | 805-261-0130
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | KARINE MATNISHYAN
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Credential | RN, BSN
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Telephone | 818-392-0554
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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