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General NPI Number Information
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NPI Number | 1629622428
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Entity Type | Organization
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Legal Business Name | BRIDGING COMMUNITIES
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Dates
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Enumeration Date | 07/30/2019
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Last Update Date | 07/30/2019
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Provider Practice Location Address
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Address Line | 2715 POTEET DR
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City | MESQUITE
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State | TX
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Zip | 75150-4943
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Country | US
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Telephone | 214-244-2788
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Fax |
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Provider Business Mailing Address
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Address Line | 2715 POTEET DR
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City | MESQUITE
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State | TX
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Zip | 75150-4943
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/PROGRAM MANAGER
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Name | CAROL EDINBYRD
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Credential |
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Telephone | 214-244-2788
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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