Organization
BRIGHT LIFE CARE RECOVERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIGHT NGABIRE NTIMPA (ADMINISTRATOR/OWNER)
(602) 904-0088
Entity
Organization
Contact information
Practice address
5060 N 19TH AVE STE 317, PHOENIX, AZ 85015-3213
(602) 904-0088
Mailing address
2220 W MISSION LN APT 2092, PHOENIX, AZ 85021-2896
(602) 904-0088
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251J00000X
Nursing Care Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261Q00000X
Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
261QR0800X
Recovery Care Clinic/Center
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
05/17/2023
Last updated
05/17/2023
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