MEDICARE: BRIGHTON HOSPICE INDIANA 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	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1699235887
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIGHTON HOSPICE INDIANA LLC

Provider Business Mailing Address
First Line	:	9800 S MONROE ST # 900
Second Line	:
City	:	SANDY
State	:	UT
Zip	:	84070-4419
Country	:	US
Telephone Number	:	801-996-3217
Fax Number	:	801-849-0476

Provider Business Practice Location Address
First Line	:	280 E 96TH ST STE 350
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46240-3858
Country	:	US
Telephone Number	:	317-300-1694
Fax Number	:	317-559-6981

Authorized Official
Title or Position	:	OWNER
Name	:	THOMAS GODFREY
Credential	:
Telephone Number	:	801-849-0486

Provider Enumeration Date	:	03/22/2019
Last Update Date	:	01/30/2026

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