Organization
BRIDGEBUILDERS FAMILY & YOUTH SERVICES INC.
Active
Organization
BRIDGEBUILDERS FAMILY & YOUTH SERVICES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VERNON TYRONNE GRIER B.A. (EXECUTIVE DIRECTOR)
(704) 864-4623
Entity
Organization
Contact information
Practice address
1219 CAMBRIDGE AVE, GASTONIA, NC 28054-1528
(704) 864-4623
(704) 864-3331
Mailing address
PO BOX 3707, GASTONIA, NC 28054-0020
(704) 864-4623
(704) 864-3331
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
MHS-036-219
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6604145
—
NC
Enumeration date
08/14/2007
Last updated
01/24/2008
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