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General NPI Number Information
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NPI Number | 1760070924
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Entity Type | Organization
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Legal Business Name | A BRIGHTER CONNECTION
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Dates
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Enumeration Date | 01/04/2021
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Last Update Date | 01/04/2021
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Provider Practice Location Address
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Address Line | 1290 CEDAR CENTER DR
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City | TALLAHASSEE
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State | FL
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Zip | 32301-4876
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Country | US
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Telephone | 850-895-9452
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Fax |
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Provider Business Mailing Address
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Address Line | 8021 PIN OAK RD
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City | TALLAHASSEE
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State | FL
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Zip | 32305-0721
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Country | US
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Telephone | 850-895-9452
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. TAMEKA FOOTMAN
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Credential | BSW,CWCM
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Telephone | 850-895-9452
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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