Provider Demographics
NPI:1013938612
Name:FAMILY BRIDGE INTERNATIONAL INC
Entity Type:Organization
Organization Name:FAMILY BRIDGE INTERNATIONAL INC
Other - Org Name:N/A
Other - Org Type:Other Name
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CORDELIA
Authorized Official - Middle Name:O
Authorized Official - Last Name:OKWANDU
Authorized Official - Suffix:
Authorized Official - Credentials:BBA, MA, CNA
Authorized Official - Phone:770-231-7661
Mailing Address - Street 1:515 MUNDYS MILL RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30238-5945
Mailing Address - Country:US
Mailing Address - Phone:770-231-7661
Mailing Address - Fax:770-210-8497
Practice Address - Street 1:515 MUNDYS MILL RD
Practice Address - Street 2:SUITE A
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30238-5945
Practice Address - Country:US
Practice Address - Phone:770-231-7661
Practice Address - Fax:770-210-8497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA031-R-0035251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health