Provider Demographics
NPI:1306718226
Name:YOUR BRIDGE OF HOPE, INC.
Entity type:Organization
Organization Name:YOUR BRIDGE OF HOPE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TAM'MEKA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BERRY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:414-368-0256
Mailing Address - Street 1:345 W SAINT PAUL AVE UNIT 197
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53201-2211
Mailing Address - Country:US
Mailing Address - Phone:414-368-0256
Mailing Address - Fax:414-413-4542
Practice Address - Street 1:345 W SAINT PAUL AVE UNIT 197
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53201-2211
Practice Address - Country:US
Practice Address - Phone:414-368-0256
Practice Address - Fax:414-413-4542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-19
Last Update Date:2025-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealthGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty