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General NPI Number Information
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NPI Number | 1629750237
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Entity Type | Organization
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Legal Business Name | BRIGHTER NEW LIFE LLC
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Dates
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Enumeration Date | 08/02/2023
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Last Update Date | 08/08/2025
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Provider Practice Location Address
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Address Line | 515 E BRADDOCK RD STE B
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City | ALEXANDRIA
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State | VA
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Zip | 22314-2161
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Country | US
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Telephone | 804-833-4477
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Fax |
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Provider Business Mailing Address
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Address Line | 515 E BRADDOCK RD STE B
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City | ALEXANDRIA
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State | VA
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Zip | 22314-2161
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Country | US
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Telephone | 804-833-4477
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MICHELLE JOHNSON-FISHER
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Credential |
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Telephone | 804-833-4477
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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 |
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License Number State |
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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 |
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Taxonomy #3
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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