Provider Demographics
NPI:1801459557
Name:BRIGHT START BEHAVIORAL SERVICES
Entity type:Organization
Organization Name:BRIGHT START BEHAVIORAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:COCO
Authorized Official - Last Name:EGNATUK
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA, LBA, MED
Authorized Official - Phone:512-705-7091
Mailing Address - Street 1:108 W 15TH ST
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-7216
Mailing Address - Country:US
Mailing Address - Phone:512-705-7091
Mailing Address - Fax:
Practice Address - Street 1:3026 RYAN ST
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-8513
Practice Address - Country:US
Practice Address - Phone:512-705-7091
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-18
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty