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General NPI Number Information
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NPI Number | 1497196174
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Entity Type | Organization
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Legal Business Name | BRIGHT BEHAVIORAL HEALTH LLC
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Dates
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Enumeration Date | 07/10/2013
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Last Update Date | 09/18/2013
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Provider Practice Location Address
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Address Line | 4880 W UNIVERSITY AVE STE B5
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City | LAS VEGAS
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State | NV
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Zip | 89103-3830
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Country | US
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Telephone | 702-826-2890
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Fax | 702-826-2879
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Provider Business Mailing Address
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Address Line | 4880 W UNIVERSITY AVE STE B5
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City | LAS VEGAS
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State | NV
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Zip | 89103-3830
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Country | US
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Telephone | 702-826-2890
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Fax | 702-826-2879
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Authorized Official
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Title or Position | OWNER
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Name | ARASH YAZDANPANAH
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Credential |
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Telephone | 702-826-2890
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 2000056.062-120
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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