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NPI Code Detail

MEDICARE: BRIGHT HOME CARE LLC

MEDICARE: BRIGHT HOME CARE 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
1251E00000XHome Health Agency

General Provider Information

NPI Number : 1528698842
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRIGHT HOME CARE LLC
Provider Business Mailing Address
First Line : 3845 HIAWATHA AVE APT 510
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55406-4454
Country : US
Telephone Number : 312-714-3770
Fax Number :
Provider Business Practice Location Address
First Line : 3845 HIAWATHA AVE APT 510
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55406-4454
Country : US
Telephone Number : 312-714-3770
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MRS. NAJMA MOALLIN
Credential :
Telephone Number : 312-714-3770
Provider Enumeration Date : 01/26/2020
Last Update Date : 01/28/2020

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