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General NPI Number Information
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NPI Number | 1851271605
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Entity Type | Organization
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Legal Business Name | BRIGHTWELL MI, LLC
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Dates
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Enumeration Date | 09/03/2025
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 6245 INKSTER RD FL 3
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City | GARDEN CITY
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State | MI
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Zip | 48135-4001
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Country | US
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Telephone | 248-277-2806
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Fax |
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Provider Business Mailing Address
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Address Line | 3512 COOLIDGE RD
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City | EAST LANSING
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State | MI
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Zip | 48823-6376
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JAFAR NAZEER
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Credential |
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Telephone | 248-277-2806
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number |
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License Number State |
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