Organization
BRIDGE OF HOPE WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. O'DELL GRAHAM LCMHC (OWNER)
(910) 297-6430
Entity
Organization
Contact information
Practice address
1001 MAIN STREET, SUITE A, FAIR BLUFF, NC 28439
(910) 632-0234
Mailing address
47 COMBINE LN SE, LELAND, NC 28451-9651
(910) 297-6430
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/06/2024
Last updated
09/06/2024
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