MEDICARE: BRIGHTER HOME HEALTH 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
1	251E00000X	Home Health Agency	98632	MN

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	:	1598177180
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIGHTER HOME HEALTH CARE, LLC

Provider Business Mailing Address
First Line	:	4111 CENTRAL AVE NE
Second Line	:	SUITE 201-D
City	:	COLUMBIA HEIGHTS
State	:	MN
Zip	:	55421-2953
Country	:	US
Telephone Number	:	763-432-5637
Fax Number	:	763-432-3866

Provider Business Practice Location Address
First Line	:	4111 CENTRAL AVE NE
Second Line	:	SUITE 201-D
City	:	COLUMBIA HEIGHTS
State	:	MN
Zip	:	55421-2953
Country	:	US
Telephone Number	:	763-432-5637
Fax Number	:	763-432-3866

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MISS ZAYNA ALI SHIRE
Credential	:
Telephone Number	:	651-269-6520

Provider Enumeration Date	:	05/29/2014
Last Update Date	:	04/21/2015

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