Organization
BRIDGES GROUP HOME, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JOAN YOUNG (OWNER/QP)
(910) 785-2367
Entity
Organization
Contact information
Practice address
1274 NC HIGHWAY 41 S, LUMBERTON, NC 28358-0215
(910) 785-2667
Mailing address
1274 NC HIGHWAY 41 S, LUMBERTON, NC 28358-0000
(910) 785-2667
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL-078-169
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6603908
—
NC
Enumeration date
08/29/2007
Last updated
08/29/2007
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