Healthcare Provider Details

I. General information

NPI: 1215863287
Provider Name (Legal Business Name): BRIDGETON SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1914 J N PEASE PL
CHARLOTTE NC
28262-4504
US

IV. Provider business mailing address

1914 J N PEASE PL
CHARLOTTE NC
28262-4504
US

V. Phone/Fax

Practice location:
  • Phone: 412-607-3572
  • Fax: 980-276-3029
Mailing address:
  • Phone: 412-607-3572
  • Fax: 980-276-3029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: FREDA MONTGOMERY
Title or Position: CEO
Credential:
Phone: 412-607-3572