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Organization

BRIGHT PATH SUPPORT SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
FRANCHECA QUYONNIA BALLARD MS (CEO)
(219) 614-6234
Entity
Organization

Contact information

Practice address
615 E 92ND PL, MERRILLVILLE, IN 46410-8111
(219) 614-6234
Mailing address
615 E 92ND PL, MERRILLVILLE, IN 46410-8111
(219) 614-6234

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
201811061287762
BUSINESS ID
IN
Enumeration date
01/03/2019
Last updated
01/03/2019
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  • Eligibility checks
  • EDI platform