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General NPI Number Information
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NPI Number | 1457729857
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Entity Type | Organization
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Legal Business Name | A BRIDGE TO GROWTH, LLC
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Dates
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Enumeration Date | 09/02/2015
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Last Update Date | 09/02/2015
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Provider Practice Location Address
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Address Line | 1495 N PARK DR SUITE 102
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City | WESTON
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State | FL
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Zip | 33326-3215
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Country | US
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Telephone | 754-223-7810
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Fax | 754-223-7827
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Provider Business Mailing Address
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Address Line | 1495 N PARK DR SUITE 102
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City | WESTON
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State | FL
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Zip | 33326-3215
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Country | US
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Telephone | 754-223-7810
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Fax | 754-223-7827
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MRS. ALINA GASTESI-DE ARMAS
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Credential | MA, MED, LMHC
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Telephone | 954-319-2259
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 06
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License Number State | FL
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