Organization
BRIDGES COMMUNITY SUPPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY RANEA FOWLER M.S (TARGETED MENTAL HEALTH CASE MANAGER)
(662) 567-2319
Entity
Organization
Contact information
Practice address
5222 ANDRUS AVE, ORLANDO, FL 32810-5400
(407) 745-5022
(407) 601-4302
Mailing address
5222 ANDRUS AVE, ORLANDO, FL 32810-5400
(407) 745-5022
(407) 601-4302
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
464686250
—
FL
Enumeration date
04/02/2018
Last updated
04/02/2018
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