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General NPI Number Information
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NPI Number | 1528764693
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Entity Type | Organization
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Legal Business Name | BRIGHT PATH GROUP LLC
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Dates
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Enumeration Date | 02/01/2023
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Last Update Date | 06/24/2024
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Provider Practice Location Address
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Address Line | 7342 W ALTA VISTA RD
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City | LAVEEN
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State | AZ
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Zip | 85339-7020
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Country | US
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Telephone | 602-503-2183
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Fax |
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Provider Business Mailing Address
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Address Line | 4315 W HOPI TRL
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City | LAVEEN
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State | AZ
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Zip | 85339-2064
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Country | US
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Telephone | 602-503-2183
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GETACHEW YIRGA
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Credential |
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Telephone | 602-503-2183
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SL0600X
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Taxonomy Name | Long-Term Care Clinical Nurse Specialist
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License Number |
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License Number State |
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