Organization
BRIDGE OF RESTORATION INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIDAH EZEOKA (PROGRAM DIRECTOR)
(832) 607-4083
Entity
Organization
Contact information
Practice address
16519 WAX MALLOW DR, HOUSTON, TX 77095-1437
(281) 758-3858
Mailing address
16519 WAX MALLOW DR, HOUSTON, TX 77095-1437
(281) 758-3858
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/12/2011
Last updated
04/12/2011
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