Abrighterlightresdiential Care Home LLC

Primary specialty

Physical Disabilities Residential Treatment FacilityTaxonomy code 320700000X

License

RC7276 Issued in OK

Legal business name

ABRIGHTERLIGHTRESDIENTIAL CARE HOME LLC

Practice address

2708 S Hemlock Ave
Broken Arrow, OK 74012-0817

Phone

(918) 378-5686

Fax

(918) 286-1404

NPI assigned

Jun 10, 2015

Last updated

Jun 10, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Patti Lynn Birge

Title

Owner/Administor

Phone

(918) 378-5686

Specialties & licenses 1

Addresses

Tax ID family

A Brighter Light Residential Care Home LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• A Brighter Light Residential Care Home LLC

  • Adult Care Home Facility
  • Broken Arrow, OK
  • NPI 1699121020
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1433894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433894400000",
    "number": "1073994596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2708 S HEMLOCK AVE",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740120817",
            "telephone_number": "918-378-5686",
            "fax_number": "918-286-1404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2708 S HEMLOCK AVE",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740120817",
            "telephone_number": "918-378-5686",
            "fax_number": "918-286-1404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABRIGHTERLIGHTRESDIENTIAL CARE HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-10",
        "last_updated": "2015-06-10",
        "status": "A",
        "authorized_official_last_name": "BIRGE",
        "authorized_official_first_name": "PATTI",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER/ADMINISTOR",
        "authorized_official_telephone_number": "918-378-5686"
    },
    "taxonomies": [
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": "OK",
            "license": "RC7276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Disabilities Residential Treatment Facility in Broken Arrow, OK
• Providers in Broken Arrow, OK by specialty
• Physical Disabilities Residential Treatment Facility in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.