Organization
BRILLIANT KIDS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LARA BOGOMOLNY MS ED (MEMBER)
(917) 654-1010
Entity
Organization
Contact information
Practice address
448 NEPTUNE AVE APT 16G, BROOKLYN, NY 11224-4492
(917) 654-1010
Mailing address
448 NEPTUNE AVE APT 16G, BROOKLYN, NY 11224-4492
(917) 654-1010
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
02/23/2020
Last updated
02/23/2020
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