Provider Demographics
NPI:1588451504
Name:BRIDGE HEALTH
Entity type:Organization
Organization Name:BRIDGE HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP
Authorized Official - Prefix:DR
Authorized Official - First Name:OLUWATOYIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SOWUNMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-908-7447
Mailing Address - Street 1:309 ALDAY LN
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1274
Mailing Address - Country:US
Mailing Address - Phone:706-908-7447
Mailing Address - Fax:
Practice Address - Street 1:11301 RICHMOND AVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-6666
Practice Address - Country:US
Practice Address - Phone:706-908-7447
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)