Organization
BRIDGE TO RESOLUTION COUNSELING AND REHABILITATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY S WELLS LMHCI (CEO)
(904) 566-0200
Entity
Organization
Contact information
Practice address
5991 CHESTER AVE STE 211, JACKSONVILLE, FL 32217-2245
(904) 566-0200
Mailing address
1164 E 17TH ST, JACKSONVILLE, FL 32206-3215
(904) 566-0200
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
01/02/2019
Last updated
03/20/2019
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