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Organization

BRIGHT FROM THE START

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TIANA RAZAA (ADMINISTRATOR)
(262) 748-8644
Entity
Organization

Contact information

Practice address
625 55TH ST, KENOSHA, WI 53140-3731
(262) 748-8644
(262) 748-8644
Mailing address
625 55TH ST, KENOSHA, WI 53140-3731
(262) 748-8644
(262) 748-8644

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
12/18/2025
Last updated
12/18/2025
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