MEDICARE: SHANTELL WALKINE DBA BRIGHTER CARE

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	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
2	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285197251
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHANTELL WALKINE DBA BRIGHTER CARE

Provider Business Mailing Address
First Line	:	1860 SW FOUNTAINVIEW BLVD STE 74
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34986-4535
Country	:	US
Telephone Number	:	772-200-3771
Fax Number	:	772-302-3807

Provider Business Practice Location Address
First Line	:	1860 SW FOUNTAINVIEW BLVD STE 74
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34986-4535
Country	:	US
Telephone Number	:	772-200-3771
Fax Number	:	772-302-3807

Authorized Official
Title or Position	:	OWNER
Name	:	SHANTELL WALKINE
Credential	:
Telephone Number	:	772-828-3045

Provider Enumeration Date	:	04/08/2019
Last Update Date	:	09/10/2025

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