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General NPI Number Information
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NPI Number | 1801314893
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Entity Type | Organization
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Legal Business Name | BRILLIANT HOME CARE LLC
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Dates
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Enumeration Date | 08/30/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 6971 N FEDERAL HWY STE 401
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City | BOCA RATON
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State | FL
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Zip | 33487-1617
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Country | US
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Telephone | 561-557-1996
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Fax | 561-766-1502
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Provider Business Mailing Address
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Address Line | 6971 N FEDERAL HWY, #401
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City | BOCA RATON
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State | FL
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Zip | 33487
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Country | US
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Telephone | 561-557-1996
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Fax | 561-766-1502
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | NIKOLE STILLMAN
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Credential |
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Telephone | 561-557-1996
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 30211692
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License Number State | FL
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