Provider Demographics
NPI:1164246377
Name:BRIGHT PATH HOME CARE OF OHIO
Entity type:Organization
Organization Name:BRIGHT PATH HOME CARE OF OHIO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:YITZCHAK
Authorized Official - Middle Name:
Authorized Official - Last Name:WEIDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-641-0336
Mailing Address - Street 1:1468 W 9TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44113-1252
Mailing Address - Country:US
Mailing Address - Phone:216-223-8680
Mailing Address - Fax:
Practice Address - Street 1:1468 W 9TH ST STE 100
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44113-1252
Practice Address - Country:US
Practice Address - Phone:216-223-8680
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health