Bridge Teen Recovery, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

BRIDGE TEEN RECOVERY, LLC

Practice address

23151 Verdugo Dr
115
Laguna Hills, CA 92653-1349

Phone

(949) 716-4623

NPI assigned

Mar 24, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Gregory N. Lebon

Title

Owner

Phone

(949) 716-4623

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1300924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300924800000",
    "number": "1124327481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23151 VERDUGO DR",
            "address_2": "115",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926531349",
            "telephone_number": "949-716-4623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23151 VERDUGO DR",
            "address_2": "115",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926531349",
            "telephone_number": "949-716-4623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGE TEEN RECOVERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-24",
        "last_updated": "2011-03-24",
        "status": "A",
        "authorized_official_last_name": "LEBON",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-716-4623",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brent Ridder, MD,Inc.
• Brian D Kim DDS Inc
• Brian Hwang MD, Inc
• Brian I. Watanabe, M.D., Inc.
• Kristina M. Brickey, COTA/L
• Bright Circle Caregivers Inc
• Megan Bright, MFT 86922
• Melaney Marie Bright
• Esmeralda Briseno
• Paul A Brower, M.D.

• Community/Behavioral Health Agency in Laguna Hills, CA
• Providers in Laguna Hills, CA by specialty
• Community/Behavioral Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2011; 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.