Provider Demographics
NPI:1750620597
Name:BRIDGE TO ABILITY, INC.
Entity type:Organization
Organization Name:BRIDGE TO ABILITY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/ OPERATOR/ TEACHER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:DOWERS
Authorized Official - Last Name:BAYLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-742-4420
Mailing Address - Street 1:32506 COUNTY ROAD 473
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34788-8812
Mailing Address - Country:US
Mailing Address - Phone:352-742-4420
Mailing Address - Fax:
Practice Address - Street 1:32506 COUNTY ROAD 473
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34788-8812
Practice Address - Country:US
Practice Address - Phone:352-742-4420
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-13
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1750620597OtherDEVELOPMENTAL THERAPIST