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. ASSISTANT GENERAL COUNSEL)
(952) 836-2234
Entity
Organization
Contact information
Practice address
613 TOWNE PARK DR W, RINCON, GA 31326-5182
(508) 521-2200
(508) 427-2227
Mailing address
55 TOZER RD, BEVERLY, MA 01915-5515
(978) 969-2894
(978) 969-2637
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
08/26/2022
Last updated
01/13/2025
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