MEDICARE: BRIGHT FUTURES PSYCHIATRY 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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1851874010
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIGHT FUTURES PSYCHIATRY LLC

Provider Business Mailing Address
First Line	:	4729 OPUS DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-8694
Country	:	US
Telephone Number	:	719-289-3173
Fax Number	:	866-718-1677

Provider Business Practice Location Address
First Line	:	4729 OPUS DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-8694
Country	:	US
Telephone Number	:	719-289-3173
Fax Number	:	866-718-1677

Authorized Official
Title or Position	:	CEO
Name	:	ERIN LEE RECINOS
Credential	:	PMHNP-BC
Telephone Number	:	719-289-3173

Provider Enumeration Date	:	09/12/2018
Last Update Date	:	03/11/2021

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