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General NPI Number Information
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NPI Number | 1548653777
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Entity Type | Organization
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Legal Business Name | BRIGHT START HOME WELLNESS INC
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Dates
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Enumeration Date | 03/12/2015
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Last Update Date | 09/15/2016
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Provider Practice Location Address
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Address Line | 7688 HIGHLAND RD
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City | WATERFORD
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State | MI
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Zip | 48327-1409
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Country | US
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Telephone | 248-770-7791
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Fax |
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Provider Business Mailing Address
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Address Line | 7688 HIGHLAND RD
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City | WATERFORD
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State | MI
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Zip | 48327-1409
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MELISSA DEGROFF
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Credential | MSW
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Telephone | 734-837-4020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 6801096789
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License Number State | MI
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