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BRIDGING RESILIENCE COUNSELING SERVICES

Ambulatory Health Care Facilities Clinic/Center Adolescent and Children Mental Health

Provider NPI: 1740686252

Organization Information:
Organization Name:  BRIDGING RESILIENCE COUNSELING SERVICES
Organization is not Subpart
Authorized Official:  JACOB EUGENE JACQUEZ  OWNER  801-842-9317

Practice Location:
774 E 2100 S STE 101  SALT LAKE CITY, UT 84106-1863 US
Tel: 801-842-9317  Fax: --

Business Mailing Address:
774 E 2100 S STE 101  SALT LAKE CITY, UT 84106-1863 US
Tel: 801-842-9317  Fax: --

NPI Information:
NPI: 1740686252
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N261QM0855XAmbulatory Health Care Facilities
Clinic/Center
Adolescent and Children Mental Health
Y261QM0850XAmbulatory Health Care Facilities
Clinic/Center

Other Provider Identifiers:

IssuerNumberStateType



American Medical Association 2012 taxonomy code information

Code: 261QM0850X

Type:

Classification:



Definition:



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