Healthcare Provider Details

I. General information

NPI: 1154239911
Provider Name (Legal Business Name): BRIDGE OF HOPE BEHAVIORAL HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6106 COOPER WOODS DR
WESTERVILLE OH
43081-8775
US

IV. Provider business mailing address

6106 COOPER WOODS DR
WESTERVILLE OH
43081-8775
US

V. Phone/Fax

Practice location:
  • Phone: 614-778-1738
  • Fax:
Mailing address:
  • Phone: 614-778-1738
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: OMOEFE SHERRY EFETEVBIA
Title or Position: CEO
Credential:
Phone: 614-778-1738