Organization
BRIDGE TEEN RECOVERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY N. LEBON (OWNER)
(949) 716-4623
Entity
Organization
Contact information
Practice address
23151 VERDUGO DR, 115, LAGUNA HILLS, CA 92653-1349
(949) 716-4623
Mailing address
23151 VERDUGO DR, 115, LAGUNA HILLS, CA 92653-1349
(949) 716-4623
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
03/24/2011
Last updated
03/24/2011
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