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General NPI Number Information
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NPI Number | 1841753035
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Entity Type | Organization
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Legal Business Name | BRITE BRIDGES OF THE TREASURE COAST, INC.
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Dates
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Enumeration Date | 04/13/2019
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Last Update Date | 04/13/2019
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Provider Practice Location Address
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Address Line | 8003 PACIFIC AVE
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City | FORT PIERCE
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State | FL
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Zip | 34951-2716
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Country | US
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Telephone | 772-480-4556
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Fax |
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Provider Business Mailing Address
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Address Line | 1025 10TH CT SW
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City | VERO BEACH
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State | FL
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Zip | 32962-5424
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Country | US
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Telephone | 772-480-4556
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Fax |
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Authorized Official
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Title or Position | CEO/DIRECTOR
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Name | MS. ROSALYN WILSON
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Credential |
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Telephone | 772-480-4556
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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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