Bridge to Life LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

BRIDGE TO LIFE LLC

Practice address

924 E Baltimore St Ste 303B&C
Baltimore, MD 21202-4736

Phone

(410) 419-4975

NPI assigned

Jul 12, 2021

Last updated

Jun 28, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kelvin Bridgers

Title

Ceo

Phone

(410) 419-4975

Specialties & licenses 5

Addresses

Locations

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

{
    "created_epoch": "1626048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751068800000",
    "number": "1235701046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "924 E BALTIMORE ST STE 303B&C",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212024736",
            "telephone_number": "410-419-4975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "924 E BALTIMORE ST STE 303B&C",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212024736",
            "telephone_number": "410-419-4975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGE TO LIFE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-12",
        "last_updated": "2025-06-28",
        "certification_date": "2025-06-28",
        "status": "A",
        "authorized_official_last_name": "BRIDGERS",
        "authorized_official_first_name": "KELVIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "410-419-4975"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian W. Robertson DDS PA (West Baltimore Dental)
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• Charlene Briddell
• Jamie Briddell, NP-C
• Bridge Integrating Group Practice LLC
• Sanaai Bridgeford
• Erika Bridgeforth
• Taylor Bridgeforth
• Anna Elizabeth Bridgeman
• Bridgepark Operations, LLC (Autumn Lake Healthcare at Bridgepark)

• Mental Health Clinic/Center (Including Community Mental Health Center) in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2025; 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.