Provider Demographics
NPI:1588336887
Name:STRENGTHENING THE BRIDGE LLC
Entity type:Organization
Organization Name:STRENGTHENING THE BRIDGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:NAKIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:334-275-7786
Mailing Address - Street 1:2037 E FOUNTAIN ST
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85213-5214
Mailing Address - Country:US
Mailing Address - Phone:334-275-7786
Mailing Address - Fax:
Practice Address - Street 1:2037 E FOUNTAIN ST
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85213-5214
Practice Address - Country:US
Practice Address - Phone:334-275-7786
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services