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General NPI Number Information
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NPI Number | 1639485824
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Entity Type | Organization
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Legal Business Name | BRIDGE TO SUCCESS
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Dates
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Enumeration Date | 08/25/2010
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Last Update Date | 08/25/2010
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Provider Practice Location Address
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Address Line | 20 PARIS ST STE 4
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City | NORWAY
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State | ME
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Zip | 04268-5654
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Country | US
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Telephone | 207-744-9440
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Fax | 207-744-9441
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Provider Business Mailing Address
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Address Line | 20 PARIS ST STE 4
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City | NORWAY
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State | ME
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Zip | 04268-5654
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Country | US
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Telephone | 207-744-9440
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Fax | 207-744-9441
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Authorized Official
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Title or Position | CASE MANAGER/OWNER
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Name | MRS. KARRI LEE WHITE
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Credential | LSW
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Telephone | 207-890-0715
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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