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General NPI Number Information
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NPI Number | 1760867220
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Entity Type | Organization
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Legal Business Name | BRIGHTER HORIZON LLC
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Dates
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Enumeration Date | 07/27/2015
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Last Update Date | 07/27/2015
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Provider Practice Location Address
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Address Line | 115 N WELLS ST STE-A
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City | KOSCIUSKO
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State | MS
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Zip | 39090-3647
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Country | US
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Telephone | 662-792-2160
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Fax | 662-792-4209
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Provider Business Mailing Address
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Address Line | 115 N WELLS ST STE-A
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City | KOSCIUSKO
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State | MS
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Zip | 39090-3647
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Country | US
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Telephone | 662-792-2160
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Fax | 662-792-4209
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Authorized Official
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Title or Position | OWNER
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Name | GREGORY GRIFFIN
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Credential |
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Telephone | 662-792-2160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C1607
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License Number State | MS
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