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General NPI Number Information
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NPI Number | 1578955720
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Entity Type | Organization
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Legal Business Name | BRIGHTER VISION
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Dates
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Enumeration Date | 02/25/2015
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Last Update Date | 02/25/2015
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Provider Practice Location Address
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Address Line | 185 EDDIE ROBINSON SR DR
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City | BATON ROUGE
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State | LA
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Zip | 70802-4741
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Country | US
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Telephone | 225-329-3144
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 312
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City | ADDIS
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State | LA
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Zip | 70710-0312
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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 | PRESIDENT
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Name | ELLIOTT HARRY
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Credential |
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Telephone | 225-329-3144
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State | LA
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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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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State | LA
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Taxonomy #4
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State | LA
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