| NPI | 1760203517 |
|---|---|
| Doing Business As | BRIGHT LAKE CARE |
| Entity Type | Organization |
| Authorized Contact | TARIQ ALI Owner 612-800-4209 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2024-10-23 |
| Last Update Date | 2024-10-24 |