Organization
BRIDGEBUILDERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VERNON GRIER (CHEIF EXECUTIVE OFFICER)
(704) 864-4623
Entity
Organization
Contact information
Practice address
1752 COUNTRY CLUB RD, UNIT B, GASTONIA, NC 28054-4800
(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
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6006011
—
NC
05
—
8300697
—
NC
05
—
8300697B
—
NC
05
—
8300697G
—
NC
05
—
8300697H
—
NC
Enumeration date
12/28/2006
Last updated
08/22/2007
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