Organization
A BRIDGE TO ACHIEVEMENT NC, LLC
Active
Other names
A Bridge to Achievement
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DANA MAYMAN ALLEY MBA (CEO)
(336) 565-6363
Entity
Organization
Contact information
Practice address
1420 PLAZA DR, WINSTON SALEM, NC 27103-1470
(336) 565-6363
Mailing address
1420 PLAZA DR, WINSTON SALEM, NC 27103-1470
(336) 565-6363
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
103T00000X
Psychologist
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
XXXXXXXXX
NA
—
Enumeration date
09/07/2017
Last updated
02/22/2022
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