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NPI Code Detail

MEDICARE: BRIGHTSIDE RECOVERY

MEDICARE: BRIGHTSIDE RECOVERY
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
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1265045371
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRIGHTSIDE RECOVERY
Provider Business Mailing Address
First Line : 1667 BELVIDERE RD
Second Line :
City : BELVIDERE
State : IL
Zip : 61008-9306
Country : US
Telephone Number : 708-360-7022
Fax Number :
Provider Business Practice Location Address
First Line : 1667 BELVIDERE RD
Second Line :
City : BELVIDERE
State : IL
Zip : 61008-9306
Country : US
Telephone Number : 779-237-3550
Fax Number : 224-205-7866
Authorized Official
Title or Position : MANAGER
Name : JENNIFER KILPATRICK
Credential :
Telephone Number : 224-220-1378
Provider Enumeration Date : 08/28/2020
Last Update Date : 03/18/2022

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Directions to “BRIGHTSIDE RECOVERY ” Practice Location

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