Organization
BRIDGE BACK TO LIFE CENTER.INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. INGER LATRONDA FORD CASAC-T (CLINICAL SUBSTANCE ABUSE COUNSELOR)
(347) 731-9159
Entity
Organization
Contact information
Practice address
500 8TH AVE, SUITE 906, NEW YORK, NY 10018-6504
(212) 679-4960
(212) 679-5444
Mailing address
500 8TH AVE, SUITE 906, NEW YORK, NY 10018-6504
(212) 679-4960
(212) 679-5444
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
30303
NY
Other
Enumeration date
02/11/2016
Last updated
02/11/2016
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