| NPI | 1275104473 |
|---|---|
| Doing Business As | BRIGHTSIDE CLINIC |
| Entity Type | Organization |
| Authorized Contact | EVON ROQUEMORE CEO 888-417-5250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 1041C0700X Social Worker, Clinical | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 251S00000X Community/Behavioral Health | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2021-07-08 |
| Last Update Date | 2024-03-19 |