Organization
BUILDING NEW BRIDGES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEMETRIA (MIMI) CHARMAINE HARRIS (CEO)
(480) 207-7560
Entity
Organization
Contact information
Practice address
455 N MESA DR STE 11, MESA, AZ 85201-5936
(480) 207-7560
(480) 668-3439
Mailing address
455 N MESA DR STE 11, MESA, AZ 85201-5936
(480) 207-7560
(480) 668-3439
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
OTC6493
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
945592
—
AZ
Enumeration date
04/27/2015
Last updated
04/27/2015
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