Organization
BRIGHT TRACK KIDS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY FRANCIS DO (MEDICAL DIRECTOR)
(224) 202-7067
Entity
Organization
Contact information
Practice address
8081 W BROOKS DR, BOISE, ID 83714-9724
(224) 202-7067
(224) 526-5164
Mailing address
8081 W BROOKS DR, BOISE, ID 83714-9724
(224) 202-7067
(224) 526-5164
Taxonomy
Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
—
—
235Z00000X
Speech-Language Pathologist
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1891050746
NATIONAL PROVIDER INDENTIFIER
IL
Enumeration date
12/15/2023
Last updated
12/15/2023
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