| Bright Act Behavioral Center Llc | |
|
100 Grove St Ste 217c Worcester MA 01605-2647 | |
| (774) 431-0272 | |
| (949) 862-8636 |
| Full Name | Bright Act Behavioral Center Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 100 Grove St Ste 217c, Worcester, Massachusetts |
| Authorized Official Name and Position | Anthony N Waithanji (OWNER: MANAGING DIRECTOR) |
| Authorized Official Contact | 5085240323 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bright Act Behavioral Center Llc 36 Pioneer Ln Auburn MA 01501-1848 Ph: () - | Bright Act Behavioral Center Llc 100 Grove St Ste 217c Worcester MA 01605-2647 Ph: (774) 431-0272 |
| NPI Number | 1568120343 |
|---|---|
| Provider Enumeration Date | 11/29/2021 |
| Last Update Date | 01/24/2023 |
| Certification Date | 01/24/2023 |
| Medicare PECOS PAC ID | 1658741830 |
|---|---|
| Medicare Enrollment ID | O20230104001403 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568120343 | NPI | - | NPPES |
| 110189082A | Medicaid | MA |
| Provider Name | Grace Njeri Ngumi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174137434 PECOS PAC ID: 2466865027 Enrollment ID: I20201229001127 |
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