Organization
BRIGHT FROM THE START
Active
Other names
Bright From The Start Intergenerational Center LLC
Organization subpart
No
Provider details
NPI number
Authorized official
TIANA RAZAA (OWNER)
(262) 605-2221
Entity
Organization
Contact information
Practice address
625 55TH ST, KENOSHA, WI 53140-3731
(262) 605-2221
Mailing address
625 55TH ST, KENOSHA, WI 53140-3731
(262) 605-2221
Taxonomy
Speciality
Code
Description
License number
State
261QF0050X
Non-Surgical Family Planning Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100176256
—
WI
Enumeration date
08/16/2021
Last updated
08/16/2021
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