Provider Demographics
NPI:1871338103
Name:BRIGHTLIFE ENHANCEMENT SERVICES, L.L.C
Entity type:Organization
Organization Name:BRIGHTLIFE ENHANCEMENT SERVICES, L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ISLAMMIYYAH
Authorized Official - Middle Name:
Authorized Official - Last Name:AL-AMEEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-988-2626
Mailing Address - Street 1:226 N POTOMAC ST
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-3813
Mailing Address - Country:US
Mailing Address - Phone:410-988-2655
Mailing Address - Fax:410-988-2626
Practice Address - Street 1:226 N POTOMAC ST
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-3813
Practice Address - Country:US
Practice Address - Phone:410-988-2655
Practice Address - Fax:410-988-2626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-27
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center