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Organization
BRIDGES COMMUNITY SUPPORT SERVICES
Active
Organization
BRIDGES COMMUNITY SUPPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY RANEA FOWLER M.S (TARGETED MENTAL HEALTH CASE MANAGER)
(662) 567-2319
Entity
Organization
Contact information
Practice address
5222 ANDRUS AVE, ORLANDO, FL 32810-5400
(407) 745-5022
(407) 601-4302
Mailing address
5222 ANDRUS AVE, ORLANDO, FL 32810-5400
(407) 745-5022
(407) 601-4302
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
464686250
—
FL
Enumeration date
04/02/2018
Last updated
04/02/2018
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