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Organization

BRIDGE BEHAVIORAL HEALTH

Active
Organization subpart
No

Provider details

NPI number
Authorized official
EBUNOLUWA MIKIE (CEO AND OWNER)
(404) 917-5484
Entity
Organization

Contact information

Practice address
324 E BROAD STREET, SUITE 109B, GRIFFIN, GA 30223
(770) 678-0038
(770) 678-0038
Mailing address
PO BOX 517, LOCUST GROVE, GA 30248-0517
(770) 678-0038
(770) 796-7726

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary

Other

Enumeration date
05/19/2025
Last updated
09/28/2025
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