Organization · NPI-2

A Bridge To Achievement

Clinic/Center · Winston Salem, NC

NPI number1386201150
StatusActive
Last updated in NPPESJun 11, 2019

Details

NPI
1386201150
Entity type
Organization (NPI-2)
Legal business name
A Bridge To Achievement
Organization subpart
No
Enumeration date
May 28, 2019
Last updated
Jun 11, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/Center––Yes

Practice location

1959 N Peace Haven Rd # 104
Winston Salem, NC 27106-4850

Phone 336-560-7878

Mailing address

1959 N Peace Haven Rd # 104
Winston Salem, NC 27106-4850

Phone 336-560-7878 · Fax 833-772-8118

Authorized official

Dana Alley
Chief Excecutive Officer
3365607878

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