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General NPI Number Information
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NPI Number | 1619116076
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Entity Type | Organization
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Legal Business Name | THE METROPOLITAN SPIRIT D/B/A/ BRIGHTSTAR HEALTHCARE
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Dates
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Enumeration Date | 02/09/2009
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Last Update Date | 02/09/2009
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Provider Practice Location Address
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Address Line | 825 RUSSELL ST
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City | AUGUSTA
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State | GA
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Zip | 30904-4216
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Country | US
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Telephone | 706-922-8800
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Fax | 706-922-8803
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Provider Business Mailing Address
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Address Line | 825 RUSSELL ST
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City | AUGUSTA
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State | GA
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Zip | 30904-4216
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Country | US
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Telephone | 706-922-8800
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Fax | 706-922-8803
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | MR. JAMES DAVID VANTREASE
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Credential |
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Telephone | 706-922-8800
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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 | PENDING
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License Number State | GA
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