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Organization
BRIDGE TO LIFE LLC
Active
Organization
BRIDGE TO LIFE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELVIN BRIDGERS (CEO)
(410) 419-4975
Entity
Organization
Contact information
Practice address
924 E BALTIMORE ST STE 303B&C, BALTIMORE, MD 21202-4736
(410) 419-4975
Mailing address
924 E BALTIMORE ST STE 303B&C, BALTIMORE, MD 21202-4736
(410) 419-4975
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
07/12/2021
Last updated
06/28/2025
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