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Organization
THE BRIDGE AUTISM CLINIC LLC
Active
Organization
THE BRIDGE AUTISM CLINIC LLC
Active
Parent organization
THE BRIDGE AUTISM CLINIC LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE BRIDGE AUTISM CLINIC LLC
Authorized official
MELISSA HAMILTON (DIRECTOR CEO)
(651) 493-8412
Entity
Organization
Contact information
Practice address
690 CLEVELAND AVE SOUTH, SUITE 100, ST PAUL, MN 55116
(612) 216-4647
Mailing address
690 CLEVELAND AVE S # 100, SAINT PAUL, MN 55116-1319
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
08/08/2019
Last updated
12/10/2019
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