Organization
RESTORED BRIDGES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
O'NEIL WALKER (CEO)
(980) 613-5304
Entity
Organization
Contact information
Practice address
718 MADISON ST, LINCOLNTON, NC 28092-2448
(980) 522-8260
Mailing address
401 HAWTHORNE LN, 110 - #312, CHARLOTTE, NC 28204
(980) 522-8260
Taxonomy
Speciality
Code
Description
License number
State
177F00000X
Lodging Provider
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
01/12/2022
Last updated
07/31/2023
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