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Organization

FBTC TRANSITIONAL SUB, LLC

Active
Other names
Bright Light
Organization subpart
No

Provider details

NPI number
Authorized official
MARY PATRICIA RODENBERG-ROBERTS (VP & SR. ASST GENERAL COUNSEL)
(952) 836-2234
Entity
Organization

Contact information

Practice address
1216 MANN DR, MATTHEWS, NC 28105-5512
(980) 262-3043
(980) 339-5617
Mailing address
55 TOZER RD, BEVERLY, MA 01915-5515
(978) 969-2894
(978) 969-2637

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
11/13/2023
Last updated
11/27/2023
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