Organization
BRIDGES BTC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID MARTIN COOKE (PRESIDENT/CEO)
(321) 690-3464
Entity
Organization
Contact information
Practice address
1694 CEDAR ST, ROCKLEDGE, FL 32955-3131
(321) 690-3464
(321) 690-3467
Mailing address
1694 CEDAR ST, ROCKLEDGE, FL 32955-3131
(321) 690-3464
(321) 690-3467
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
16168
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024164496
—
FL
Enumeration date
05/30/2013
Last updated
05/30/2013
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