| Entity Name: | BRIGHTWAY PSYCHIATRY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 11 Jul 2023 (2 years ago) |
| Document Number: | L23000328186 |
| FEI/EIN Number | 93-3817304 |
| Address: | 9870 WATERMILL CICLE, E, BOYNTON BEACH, FL, 33437, US |
| Mail Address: | 9870 WATERMILL CIRCLE, E, BOYNTON BEACH, FL, 33437, US |
| ZIP code: | 33437 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1891558649 | 2024-02-05 | 2024-02-05 | 9870 WATERMILL CIR APT E, BOYNTON BEACH, FL, 334372815, US | 9870 WATERMILL CIR APT E, BOYNTON BEACH, FL, 334372815, US | |||||||||||||||||||
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| Phone | +1 321-368-4868 |
| Phone | +1 561-608-0088 |
Authorized person
| Name | VANISE BASTIEN |
| Role | APRN |
| Phone | 3213684868 |
Taxonomy
| Taxonomy Code | 261QM0855X - Adolescent and Children Mental Health Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BASTIEN VANISE | Agent | 9870 WATERMILL CIRCLE, BOYNTON BEACH, FL, 33437 |
| Name | Role | Address |
|---|---|---|
| BASTIEN VANISE | Manager | 9870 WATERMILL CIRCLE, UNIT E, BOYNTON BEACH, FL, 33437 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-22 |
| Florida Limited Liability | 2023-07-11 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
