Provider Demographics
NPI:1467627414
Name:BUILDING BRIDGES YOUTH RESIDENTIAL TREATMENT FACILIY, LLC
Entity Type:Organization
Organization Name:BUILDING BRIDGES YOUTH RESIDENTIAL TREATMENT FACILIY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/BUSINESS OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:STITH
Authorized Official - Last Name:CHRISP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-359-9795
Mailing Address - Street 1:1670 ROCK PILLAR RD
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520-7889
Mailing Address - Country:US
Mailing Address - Phone:919-359-9795
Mailing Address - Fax:
Practice Address - Street 1:1670 ROCK PILLAR RD
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-7889
Practice Address - Country:US
Practice Address - Phone:919-359-9795
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children