BRIGHT SHADOWS CORPORATION NPI 1184503237

NPI Information

  • NPI: 1184503237
  • Provider Name: BRIGHT SHADOWS CORPORATION
  • Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
  • Entity Type: Organization
  • :
  • Address: 524 S ROAD ST
    ELIZABETH CITY, NC
    ZIP 27909
  • Phone: (252) 751-5103

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NPI Details

BRIGHT SHADOWS CORPORATION is a community based residential treatment facility mental illness in Elizabeth City, NC. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. BRIGHT SHADOWS CORPORATION NPI is 1184503237. The provider is registered as an organization entity type and is a multi-specialty group.
The provider .

The provider's business location address is:

524 S ROAD ST
ELIZABETH CITY, NC
ZIP 27909-912
Phone: (252) 751-5103
Fax: (252) 751-5127

The provider's authorized official is Rondeshya Keyonna Cosby .
The authorized official title is Director and has the following contact phone number (252) 263-5787.

The enumeration date for this NPI number is 9/1/2025 and was last updated on 9/2/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YM0800XCounselorMental HealthNo
2104100000XSocial WorkerNo
3106S00000XBehavior TechnicianNo
4163W00000XRegistered NurseNo
5261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)No
6323P00000XPsychiatric Residential Treatment FacilityNo
7363LF0000XNurse PractitionerFamilyNo
8363LP0808XNurse PractitionerPsychiatric/Mental HealthNo
9320800000XCommunity Based Residential Treatment Facility, Mental IllnessYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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