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General NPI Number Information
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NPI Number | 1649674029
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Entity Type | Organization
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Legal Business Name | BRIDGE TO MENTAL HEALING LLC
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Dates
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Enumeration Date | 10/14/2014
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Last Update Date | 05/25/2016
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Provider Practice Location Address
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Address Line | 319 CLEMATIS ST SUITE 316
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City | WEST PALM BEACH
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State | FL
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Zip | 33401-4608
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Country | US
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Telephone | 561-307-5843
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Fax | 561-328-3441
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Provider Business Mailing Address
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Address Line | 8129 SEDGEWICK CT APT. A
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City | WEST PALM BEACH
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State | FL
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Zip | 33406-8472
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Country | US
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Telephone | 561-307-5843
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Fax | 561-328-3441
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Authorized Official
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Title or Position | OWNER
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Name | MS. LINNETTE SANTOS ROBLES
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Credential | LMHC
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Telephone | 561-307-5843
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | MH12636
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License Number State | FL
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