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Organization
BRIGHTER SMILE SUPPORTIVE LIVING SERVICE
Active
Organization
BRIGHTER SMILE SUPPORTIVE LIVING SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TIESHAE HUNTSMAN (CEO)
(562) 679-3559
Entity
Organization
Contact information
Practice address
4118 CRENSHAW BLVD, LOS ANGELES, CA 90008-2502
(562) 679-3559
Mailing address
4118 CRENSHAW BLVD, LOS ANGELES, CA 90008-2502
(562) 679-3559
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
174200000X
Meals Provider
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
335G00000X
Medical Foods Supplier
—
—
347C00000X
Private Vehicle
—
—
Other
Enumeration date
08/05/2026
Last updated
08/05/2026
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