Active NPI
Brightway Healthcare Group, Inc.
- Community/Behavioral Health Agency
- Lake Mary, FL
National Provider Identifier
1609695071
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- BRIGHTWAY HEALTHCARE GROUP, INC.
- Practice address
- 532 Teton St
Lake Mary, FL 32746-2219 - Phone
- (321) 363-1576
- NPI assigned
- Oct 3, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Lacy-Ann Momanyi
- Title
- Owner/Ceo
- Phone
- (321) 363-1576
Specialties & licenses 15
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | |||
| Developmentally Disabled Services Day Training Agency | 251C00000X | |||
| Nursing Care Agency | 251J00000X | |||
| Community/Behavioral Health Agency | 251S00000X | Primary | ||
| Developmental Disabilities Clinic/Center | 261QD1600X | |||
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | |||
| Adult Mental Health Clinic/Center | 261QM0850X | |||
| Assisted Living Facility (Mental Illness) | 3104A0625X | |||
| Assisted Living Facility (Behavioral Disturbances) | 3104A0630X | |||
| Intellectual and/or Developmental Disabilities Residential Treatment Facility | 320600000X | |||
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | |||
| Substance Abuse Rehabilitation Facility | 324500000X | |||
| Land Ambulance | 3416L0300X | |||
| Respite Care | 385H00000X | |||
| Child Intellectual and/or Developmental Disabilities Respite Care | 385HR2060X |
Addresses
Primary practice location
532 Teton St
Lake Mary, FL 32746-2219
Mailing address
532 Teton St
Lake Mary, FL 32746-2219
Phone (321) 363-1576
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1727913600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1727913600000",
"number": "1609695071",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "532 TETON ST",
"city": "LAKE MARY",
"state": "FL",
"postal_code": "327462219",
"telephone_number": "321-363-1576"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "532 TETON ST",
"city": "LAKE MARY",
"state": "FL",
"postal_code": "327462219",
"telephone_number": "321-363-1576"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BRIGHTWAY HEALTHCARE GROUP, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2024-10-03",
"last_updated": "2024-10-03",
"certification_date": "2024-10-03",
"status": "A",
"authorized_official_last_name": "MOMANYI",
"authorized_official_first_name": "LACY-ANN",
"authorized_official_title_or_position": "OWNER/CEO",
"authorized_official_telephone_number": "321-363-1576"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": false
},
{
"code": "251C00000X",
"taxonomy_group": "",
"desc": "Day Training, Developmentally Disabled Services",
"state": null,
"license": null,
"primary": false
},
{
"code": "251J00000X",
"taxonomy_group": "",
"desc": "Nursing Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": true
},
{
"code": "261QD1600X",
"taxonomy_group": "",
"desc": "Clinic/Center, Developmental Disabilities",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QM0801X",
"taxonomy_group": "",
"desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QM0850X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adult Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "3104A0625X",
"taxonomy_group": "",
"desc": "Assisted Living Facility, Assisted Living, Mental Illness",
"state": null,
"license": null,
"primary": false
},
{
"code": "3104A0630X",
"taxonomy_group": "",
"desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
"state": null,
"license": null,
"primary": false
},
{
"code": "320600000X",
"taxonomy_group": "",
"desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
"state": null,
"license": null,
"primary": false
},
{
"code": "320900000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
"state": null,
"license": null,
"primary": false
},
{
"code": "324500000X",
"taxonomy_group": "",
"desc": "Substance Abuse Rehabilitation Facility",
"state": null,
"license": null,
"primary": false
},
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": null,
"license": null,
"primary": false
},
{
"code": "385H00000X",
"taxonomy_group": "",
"desc": "Respite Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "385HR2060X",
"taxonomy_group": "",
"desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lake Mary, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.