Organization
BRIDGE TO SUCCESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY DAVIS (CREDENTIALING SPECIALISTS)
(912) 373-4385
Entity
Organization
Contact information
Practice address
107 WADE ST STE C, JAMESTOWN, NC 27282-9567
(704) 433-5175
Mailing address
345 BONANZA DR, SALISBURY, NC 28144-9422
(704) 433-5175
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/25/2022
Last updated
06/22/2022
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