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General NPI Number Information
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NPI Number | 1508676305
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Entity Type | Organization
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Legal Business Name | BRIGHTER MIND CARE LLC
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Dates
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Enumeration Date | 01/13/2025
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 7901 4TH ST N
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City | ST PETERSBURG
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State | FL
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Zip | 33702-4305
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Country | US
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Telephone | 863-312-8445
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Fax |
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Provider Business Mailing Address
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Address Line | 25 HARBOR INN RD
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City | BAYVILLE
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State | NJ
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Zip | 08721-3512
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Country | US
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Telephone | 863-312-8445
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | AZEEZ A AROWOLO
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Credential |
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Telephone | 732-731-9617
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health 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 | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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