Healthcare Provider Details

I. General information

NPI: 1730024217
Provider Name (Legal Business Name): BRIDGE TO BALANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

176 W BONNER DR
MOUNTAIN HOUSE CA
95391-1358
US

IV. Provider business mailing address

176 W BONNER DR
MOUNTAIN HOUSE CA
95391-1358
US

V. Phone/Fax

Practice location:
  • Phone: 510-773-6788
  • Fax:
Mailing address:
  • Phone: 510-773-6788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: HELEN RAINES-AUSTIN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 510-773-6788