Provider Demographics
NPI:1316743792
Name:BRIGHT TIDES ABA, LLC
Entity type:Organization
Organization Name:BRIGHT TIDES ABA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:ADELE
Authorized Official - Last Name:TOUPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-229-7777
Mailing Address - Street 1:616 LOST KEY DR UNIT 604A
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32507-3685
Mailing Address - Country:US
Mailing Address - Phone:225-229-7777
Mailing Address - Fax:
Practice Address - Street 1:616 LOST KEY DR UNIT 604A
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32507-3685
Practice Address - Country:US
Practice Address - Phone:225-229-7777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty