| NPI | 1063282689 |
|---|---|
| Other Name | BRIDGE 2 SUCCESS GROUP HOME |
| Entity Type | Organization |
| Authorized Contact | LEKEYSHA DENISE AYENUMELO Executive Director 336-307-3845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2024-01-04 |
| Last Update Date | 2024-01-04 |