Provider Demographics
NPI:1972631141
Name:A BRIDGE TO RECOVERY
Entity type:Organization
Organization Name:A BRIDGE TO RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:GILBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-977-9353
Mailing Address - Street 1:361 TOWNE CENTER BLVD
Mailing Address - Street 2:STE 1300
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39157-4863
Mailing Address - Country:US
Mailing Address - Phone:601-977-9353
Mailing Address - Fax:
Practice Address - Street 1:361 TOWNE CENTER BLVD
Practice Address - Street 2:STE 1300
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-4863
Practice Address - Country:US
Practice Address - Phone:601-977-9353
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1225101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty