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General NPI Number Information
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NPI Number | 1629968037
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Entity Type | Organization
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Legal Business Name | BRIGHTON RESIDENTIAL SERVICES LLC
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Dates
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Enumeration Date | 07/07/2025
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Last Update Date | 09/13/2025
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Provider Practice Location Address
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Address Line | 20 FOX CHASE RD
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City | BLOOMFIELD
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State | CT
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Zip | 06002-2152
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Country | US
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Telephone | 860-890-3089
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Fax |
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Provider Business Mailing Address
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Address Line | 20 FOX CHASE RD
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City | BLOOMFIELD
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State | CT
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Zip | 06002-2152
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Country | US
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Telephone | 860-890-3089
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. AMOS JACK
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Credential |
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Telephone | 860-305-6723
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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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 | 347C00000X
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Taxonomy Name | Private Vehicle
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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 | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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