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General NPI Number Information
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NPI Number | 1487120390
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Entity Type | Organization
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Legal Business Name | BRIGHT WAY SERVICES INC
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Dates
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Enumeration Date | 10/17/2018
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Last Update Date | 10/17/2018
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Provider Practice Location Address
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Address Line | 504 E PENNSYLVANIA BLVD
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City | TREVOSE
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State | PA
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Zip | 19053-7848
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Country | US
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Telephone | 800-688-2552
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Fax | 800-688-2552
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Provider Business Mailing Address
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Address Line | 504 E PENNSYLVANIA BLVD
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City | TREVOSE
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State | PA
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Zip | 19053-7848
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Country | US
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Telephone | 800-688-2552
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Fax | 800-688-2552
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Authorized Official
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Title or Position | PRESIDENT
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Name | VLAD BRODSKY
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Credential |
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Telephone | 800-688-2552
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training 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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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Taxonomy #3
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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Taxonomy #4
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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Taxonomy #5
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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