Organization
BRIDGE BACK TO LIFE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY DEMMA (DIRECTOR)
(212) 679-4960
Entity
Organization
Contact information
Practice address
500 8TH AVE RM 906, NEW YORK, NY 10018-4190
(212) 679-4960
(212) 399-5444
Mailing address
500 8TH AVE RM 906, NEW YORK, NY 10018-4190
Taxonomy
Speciality
Code
Description
License number
State
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
03/03/2016
Last updated
03/03/2016
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