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General NPI Number Information
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NPI Number | 1194564112
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Entity Type | Organization
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Legal Business Name | BRIGHT PATHWAYS ABA HI LLC
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Dates
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Enumeration Date | 05/20/2024
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Last Update Date | 12/08/2024
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Provider Practice Location Address
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Address Line | 200 N VINEYARD BLVD # A3255500
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City | HONOLULU
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State | HI
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Zip | 96817-3950
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Country | US
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Telephone | 424-261-9111
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Fax |
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Provider Business Mailing Address
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Address Line | 1519 RIPLEY ST
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City | PHILADELPHIA
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State | PA
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Zip | 19111-2821
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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 | OWNER
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Name | MR. MOSHE COLEMAN
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Credential |
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Telephone | 424-261-9111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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