# BRIDGE TO INDEPENDENT LIVING, LLC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003205261
- **Authorized official:** MRS. MICHELLE ANTOINETTE CAVINESS (PRESIDENT/CEO)
- **Authorized official phone:** (202) 882-6444

## Contact information

- **Practice address:** 5004 2ND ST NW APT 1, WASHINGTON, DC 20011-4170
- **Practice address phone:** (231) 740-4625
- **Mailing address:** 5000 2ND ST NW APT 3, WASHINGTON, DC 20011-4171
- **Mailing address phone:** (202) 882-6444

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 01/12/2015
- **Last updated:** 01/12/2015