# BRILLIANT THERAPIES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053796813
- **Authorized official:** DOROTHY GROVER PT (PROGRAM DIRECTOR)
- **Authorized official phone:** (518) 260-0716

## Contact information

- **Practice address:** 14 OLD STATE RD S, LAKE GEORGE, NY 12845-5914
- **Practice address phone:** (518) 260-0716
- **Mailing address:** 14 OLD STATE RD S, LAKE GEORGE, NY 12845-5914

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 252Y00000X | Early Intervention Provider Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 07/22/2015
- **Last updated:** 08/14/2015