Organization
BRIGHTSIDE DAY HABILITATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LIZABETH DELL JACKSON (OWNER/MANAGER)
(225) 615-7018
Entity
Organization
Contact information
Practice address
557 E MAIN ST, A, BRUSLY, LA 70719-2210
(225) 615-7018
(225) 615-7492
Mailing address
557 E MAIN ST, A, BRUSLY, LA 70719-2210
(225) 615-7018
(225) 615-7492
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
2203781925
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HC0011192
—
LA
Enumeration date
08/21/2014
Last updated
08/21/2014
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