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General NPI Number Information
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NPI Number | 1780812263
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Entity Type | Organization
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Legal Business Name | BRIGHT STAR SPEECH AND LANGUAGE SERVICES
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Dates
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Enumeration Date | 06/23/2009
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Last Update Date | 06/23/2009
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Provider Practice Location Address
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Address Line | 26712 VIA ZARAGOSA
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City | MISSION VIEJO
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State | CA
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Zip | 92691-5025
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Country | US
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Telephone | 949-707-5962
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Fax | 949-707-5962
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Provider Business Mailing Address
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Address Line | 26712 VIA ZARAGOSA
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City | MISSION VIEJO
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State | CA
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Zip | 92691-5025
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Country | US
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Telephone | 949-707-5962
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Fax | 949-707-5962
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Authorized Official
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Title or Position | OWNER
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Name | LUISA ACOSTA
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Credential |
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Telephone | 949-707-5962
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health 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 | 252Y00000X
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Taxonomy Name | Early Intervention Provider 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 | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number | SP 10738
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License Number State | CA
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