Organization
BRIDGEBUILDERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VERNON T GRIER (CHIEF EXECUTIVE OFFICER)
(704) 864-4623
Entity
Organization
Contact information
Practice address
606 HILLSIDE DR, KINGS MTN, NC 28086-3219
(704) 864-4623
(704) 864-3331
Mailing address
PO BOX 3707, GASTONIA, NC 28054-0020
(704) 864-4623
(704) 864-3331
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL030463
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6603957
—
NC
Enumeration date
12/21/2006
Last updated
08/01/2007
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