The Bridge of Georgia School, Inc

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

THE BRIDGE OF GEORGIA SCHOOL, INC

Practice address

109 Blaine St
Monroe, GA 30655-2403

Phone

(770) 406-6111

Fax

(678) 635-8709

NPI assigned

Apr 18, 2017

Organization subpart

No

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

Authorized official

Name

Mrs. Tamila Embry Burt

Title

Executive Director

Phone

(770) 406-6111

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1492473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492473600000",
    "number": "1124552088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 BLAINE ST",
            "address_2": "PO BOX 542",
            "city": "MONROE",
            "state": "GA",
            "postal_code": "306552403",
            "telephone_number": "770-406-6111",
            "fax_number": "678-635-8709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 BLAINE ST",
            "city": "MONROE",
            "state": "GA",
            "postal_code": "306552403",
            "telephone_number": "770-406-6111",
            "fax_number": "678-635-8709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BRIDGE OF GEORGIA SCHOOL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-18",
        "last_updated": "2017-04-18",
        "status": "A",
        "authorized_official_last_name": "BURT",
        "authorized_official_first_name": "TAMILA",
        "authorized_official_middle_name": "EMBRY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "770-406-6111",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ernst Suneus, PHARMD
• Susan Denise Tackett, CPED
• Daniela Tanase, MD
• Candace Taylor Teat, FNP, BSN, RN
• The Bridge of Georgia Center Inc.
• The Doctors Delp LLC
• The Sanctuary House, Inc
• William Anthony Thornton
• TLC Best Care, LLC
• Phong Chau Truong Tran, PAC

• Developmentally Disabled Services Day Training Agency in Monroe, GA
• Providers in Monroe, GA by specialty
• Developmentally Disabled Services Day Training Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2017; 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.