Bridge to Independent Living, LLC.

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

BRIDGE TO INDEPENDENT LIVING, LLC.

Practice address

5004 2ND St NW Apt 1
Washington, DC 20011-4170

Phone

(231) 740-4625

NPI assigned

Jan 12, 2015

Organization subpart

No

Name

Mrs. Michelle Antoinette Caviness

Title

President/Ceo

Phone

(202) 882-6444

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 12, 2015.

{
    "created_epoch": "1421020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421020800000",
    "number": "1003205261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 2ND ST NW APT 3",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200114171",
            "telephone_number": "202-882-6444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5004 2ND ST NW APT 1",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200114170",
            "telephone_number": "231-740-4625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGE TO INDEPENDENT LIVING, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-12",
        "last_updated": "2015-01-12",
        "status": "A",
        "authorized_official_last_name": "CAVINESS",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "ANTOINETTE",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "202-882-6444",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Briccetti, MD
• Kelly S Briden, MD
• Bridge & Bloom, LLC
• Bridge Healthcare Inc
• Bridge Integrative Health and Nutrition
• Kirsten Bridgeford
• Mitchell Bridgeforth III
• Kisha Bridgeforth
• Sharon E Bridgeman-Shah, M.D.
• Alexus Channel Bridgers

• All providers in Washington, DC
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.