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General NPI Number Information
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NPI Number | 1619424181
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Entity Type | Organization
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Legal Business Name | BRIGHTER PROSPECTIVE RESIDENTIAL SERVICES, LLC
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Dates
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Enumeration Date | 09/01/2016
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Last Update Date | 04/29/2019
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Provider Practice Location Address
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Address Line | 2509 TONOKA ROAD
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City | HENRICO
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State | VA
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Zip | 23223
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Country | US
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Telephone | 804-386-9522
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Fax |
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Provider Business Mailing Address
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Address Line | 2509 TONOKA RD
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City | RICHMOND
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State | VA
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Zip | 23223-1739
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Country | US
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Telephone | 804-356-0947
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Fax | 804-562-2061
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Authorized Official
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Title or Position | CEO
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Name | GWENDOLYN L JORDAN
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Credential |
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Telephone | 804-562-2061
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347E00000X
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Taxonomy Name | Transportation Broker
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License Number |
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License Number State |
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