# BRIDGE BEHAVIORAL HEALTH LLC

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

## Provider details

- **NPI number:** 1255123147
- **Authorized official:** EBUNOLUWA MIKIE (CEO AND OWNER)
- **Authorized official phone:** (404) 917-5484

## Contact information

- **Practice address:** 410 E TAYLOR ST STE K2, GRIFFIN, GA 30223-3444
- **Practice address phone:** (770) 678-0038
- **Practice address fax:** (770) 678-0038
- **Mailing address:** 164 AL JENNAH BLVD, LOCUST GROVE, GA 30248-3753
- **Mailing address phone:** (770) 678-0038
- **Mailing address fax:** (770) 796-7726

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 05/19/2025
- **Last updated:** 10/03/2026