# YOUTH BRIDGE

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

## Provider details

- **NPI number:** 1679961882
- **Authorized official:** MS. NANCY RODRIGUEZ (MHPP)
- **Authorized official phone:** (479) 282-9492

## Contact information

- **Practice address:** 250 E CENTERTON BLVD, CENTERTON, AR 72719-9240
- **Practice address phone:** (479) 795-1802
- **Mailing address:** 250 E. CENTERTON BLVD., CENTERTON, AR 72758
- **Mailing address phone:** (479) 795-1802

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 12/23/2014
- **Last updated:** 12/23/2014