Organization
BRIDGE 4 HEALTH SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ARLY BRUTUS (DIRECTOR)
(678) 223-8138
Entity
Organization
Contact information
Practice address
1379 CAMELIA ST, RIVERDALE, GA 30296-1190
(678) 223-8138
Mailing address
PO BOX 142614, FAYETTEVILLE, GA 30214-6518
(678) 223-8138
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
031-R-1605
HEALTHCARE LICENSE NUMBER
GA
Enumeration date
01/24/2020
Last updated
01/24/2020
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