Organization · NPI-2

Bright Life Care Recovery Center LLC

Residential Treatment Facility, Intellectual and/or Developmental Disabilities · Phoenix, AZ

NPI number1013608496

StatusActive

Last updated in NPPESMay 17, 2023

Details

NPI: 1013608496
Entity type: Organization (NPI-2)
Legal business name: Bright Life Care Recovery Center LLC
Organization subpart: No
Enumeration date: May 17, 2023
Certification date: May 17, 2023
Last updated: May 17, 2023

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
320600000X	Residential Treatment Facility, Intellectual and/or Developmental Disabilities	–	–	Yes
261QR0800X	Clinic/Center, Recovery Care	–	–
251B00000X	Case Management	–	–
251J00000X	Nursing Care	–	–
251S00000X	Community/Behavioral Health	–	–
261Q00000X	Clinic/Center	–	–
261QM0801X	Clinic/Center, Mental Health (Including Community Mental Health Center)	–	–
261QP2000X	Clinic/Center, Physical Therapy	–	–

Practice location

5060 N 19th Ave Ste 317
Phoenix, AZ 85015-3213

Phone 602-904-0088

Mailing address

2220 W Mission Ln Apt 2092
Phoenix, AZ 85021-2896

Phone 602-904-0088

Authorized official

Bright Ngabire Ntimpa
Administrator/Owner
6029040088

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