| Bright Bee-havior Health Llc | |
|
800 Corporate Drive, Suite 356 Stafford VA 22554 | |
| (703) 539-5411 | |
| (703) 621-1800 |
| Full Name | Bright Bee-havior Health Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 800 Corporate Drive, Suite 356, Stafford, Virginia |
| Authorized Official Name and Position | Kedest Gebreselassie (OWNER/MEMBER) |
| Authorized Official Contact | 5713382764 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bright Bee-havior Health Llc 16236 Chase Eagle Lane Woodbridge VA 22191 Ph: (571) 338-2764 | Bright Bee-havior Health Llc 800 Corporate Drive, Suite 356 Stafford VA 22554 Ph: (703) 539-5411 |
| NPI Number | 1508581026 |
|---|---|
| Provider Enumeration Date | 10/06/2022 |
| Last Update Date | 06/26/2023 |
| Certification Date | 06/26/2023 |
| Medicare PECOS PAC ID | 0042684953 |
|---|---|
| Medicare Enrollment ID | O20230316000265 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508581026 | NPI | - | NPPES |
| Provider Name | Kedest Gebreselassie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265897391 PECOS PAC ID: 0941503932 Enrollment ID: I20160126000557 |
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