Organization
BRIGHTWAY HEALTHCARE GROUP, INC.
Active
Organization
BRIGHTWAY HEALTHCARE GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LACY-ANN MOMANYI (OWNER/CEO)
(321) 363-1576
Entity
Organization
Contact information
Practice address
532 TETON ST, LAKE MARY, FL 32746-2219
(321) 363-1576
Mailing address
532 TETON ST, LAKE MARY, FL 32746-2219
(321) 363-1576
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251J00000X
Nursing Care Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
3416L0300X
Land Ambulance
—
—
385H00000X
Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
10/03/2024
Last updated
10/03/2024
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