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General NPI Number Information
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NPI Number | 1770257412
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Entity Type | Organization
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Legal Business Name | BRIDGE OF CARE LLC
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Dates
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Enumeration Date | 08/05/2021
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Last Update Date | 08/05/2021
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Provider Practice Location Address
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Address Line | 2311 10TH AVE N STE 3
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City | LAKE WORTH
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State | FL
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Zip | 33461-6605
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Country | US
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Telephone | 561-899-3017
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Fax | 561-429-2622
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Provider Business Mailing Address
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Address Line | 11401 SW 40TH ST STE 345
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City | MIAMI
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State | FL
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Zip | 33165-3372
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Country | US
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Telephone | 305-603-7063
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Fax | 305-603-8705
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | YARITZA AGUIAR RODRIGUEZ
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Credential | CBHCMS
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Telephone | 305-603-7063
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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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