Organization
BRIDGE TO INDEPENDENT LIVING, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELLE ANTOINETTE CAVINESS (PRESIDENT/CEO)
(202) 882-6444
Entity
Organization
Contact information
Practice address
5004 2ND ST NW APT 1, WASHINGTON, DC 20011-4170
(231) 740-4625
Mailing address
5000 2ND ST NW APT 3, WASHINGTON, DC 20011-4171
(202) 882-6444
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
01/12/2015
Last updated
01/12/2015
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