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Organization

BUILDING BRIDGES GROUP HOME, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. CAROLYN ELAINE BEVERLY (CEO)
(540) 462-7688
Entity
Organization

Contact information

Practice address
716 FITZLEE ST, GLASGOW, VA 24555-2530
(540) 258-1098
Mailing address
716 FITZLEE ST, GLASGOW, VA 24555-2530
(540) 258-1098

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
2469-01-001
VA

Other

Enumeration date
11/23/2015
Last updated
11/23/2015
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