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General NPI Number Information
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NPI Number | 1861860199
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Entity Type | Organization
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Legal Business Name | BRIGHTSIDE HOMES INC
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Dates
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Enumeration Date | 09/03/2015
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Last Update Date | 10/22/2015
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Provider Practice Location Address
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Address Line | 4133 WHITE PINE DR
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City | RALEIGH
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State | NC
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Zip | 27612-3737
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Country | US
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Telephone | 919-986-8800
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Fax |
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Provider Business Mailing Address
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Address Line | 1721 BEACON BLUFF ST
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City | RALEIGH
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State | NC
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Zip | 27604-5446
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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 | DIRECTOR
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Name | CHRISTIANA OGIDI
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Credential | RN
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Telephone | 919-986-8800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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