Organization
BRIDGEWELL ALLIANCE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATONYA DONALD PH.D. (EXECUTIVE DIRECTOR)
(678) 599-2798
Entity
Organization
Contact information
Practice address
1999 PARKER CT, STONE MOUNTAIN, GA 30087-3651
(678) 599-2798
Mailing address
936 LOST CREEK CIR, STONE MOUNTAIN, GA 30088-2119
(678) 599-2798
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/12/2026
Last updated
05/12/2026
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