MEDICARE: BRIGHT FUTURES PSYCHIATRY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1023853975
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIGHT FUTURES PSYCHIATRY, LLC

Provider Business Mailing Address
First Line	:	4729 OPUS DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-8694
Country	:	US
Telephone Number	:	719-289-3173
Fax Number	:	866-718-1677

Provider Business Practice Location Address
First Line	:	2140 HOLLOW BROOK DR STE 210
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918-8401
Country	:	US
Telephone Number	:	719-289-3173
Fax Number	:	866-718-1677

Authorized Official
Title or Position	:	CEO
Name	:	ERIN RECINOS
Credential	:	PMHNP-BC
Telephone Number	:	719-289-3173

Provider Enumeration Date	:	07/01/2024
Last Update Date	:	07/01/2024

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