Organization
BRIDGE MANIFEST, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD TREMAYNE POWELL (CEO)
(252) 343-7002
Entity
Organization
Contact information
Practice address
319 W NORTHERN BLVD, TARBORO, NC 27886-2452
(252) 343-7002
Mailing address
319 W NORTHERN BLVD, TARBORO, NC 27886-2452
(252) 343-7002
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
—
—
311500000X
Alzheimer Center (Dementia Center)
—
—
311Z00000X
Custodial Care Facility
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
347E00000X
Transportation Broker
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Enumeration date
02/07/2026
Last updated
04/28/2026
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