Organization
THE BRIDGE ROOM INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LASHARA WALLER (CEO)
(659) 253-7144
Entity
Organization
Contact information
Practice address
125 55TH ST N, BIRMINGHAM, AL 35212-2419
(818) 817-1973
Mailing address
9816 WESTFIELD CT, BIRMINGHAM, AL 35217-2297
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251E00000X
Home Health Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Enumeration date
01/09/2023
Last updated
01/26/2023
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