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General NPI Number Information
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NPI Number | 1437093820
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Entity Type | Organization
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Legal Business Name | BRIGHTER LIVING GROUP HOMES LLC
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Dates
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Enumeration Date | 04/16/2026
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Last Update Date | 04/16/2026
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Provider Practice Location Address
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Address Line | 23067 PERU AVE
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-7122
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Country | US
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Telephone | 941-979-0112
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Fax |
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Provider Business Mailing Address
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Address Line | 23067 PERU AVE
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-7122
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Country | US
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Telephone | 941-979-0112
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATIVE ASSISTANT
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Name | MR. TYLER NELSON
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Credential | MEDICAID PROVIDESR
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Telephone | 941-979-0112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376G00000X
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Taxonomy Name | Nursing Home Administrator
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License Number |
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License Number State |
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