Bright Sky Group Home LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

BRIGHT SKY GROUP HOME LLC

Practice address

1510 18TH St
Greensboro, NC 27405-4508

Phone

(862) 621-7454

NPI assigned

Jul 10, 2024

Organization subpart

No

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

Authorized official

Name

Mrs. Mavis Boamah-Mullen

Title

Owner

Phone

(862) 621-7454

Specialties & licenses 1

Addresses

Other names 1

• Bright Sky Group Home LLC Other name

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

{
    "created_epoch": "1720569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720569600000",
    "number": "1467299198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 18TH ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274054508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 18TH ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274054508",
            "telephone_number": "862-621-7454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHT SKY GROUP HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-10",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A",
        "authorized_official_last_name": "BOAMAH-MULLEN",
        "authorized_official_first_name": "MAVIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "862-621-7454",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bright Sky Group Home LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Camille Briggs, LCMHCA
• Desiree Guinevere Briggs, LPC
• Katherine Brigham, MED RD LDN
• Bright & Early Learning
• Bright Horizons Health Care Services
• Pamela Bright, BSW
• Brighter Day, Inc
• Brighter Path Family Care
• Annel Ines Briick, DDS
• Vondra Brimage, DO

• Community/Behavioral Health Agency in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; 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.