BRIDGEWAY INC NPI 1578788188

NPI Information

NPI: 1578788188
Provider Name: BRIDGEWAY, INC
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
1220 W DIVISION ST
KEWANEE, IL
ZIP 61443
Phone: (309) 853-4325
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BRIDGEWAY, INC is a mental health (including community mental health center) clinic center in Kewanee, IL. BRIDGEWAY, INC NPI is 1578788188. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1220 W DIVISION ST
KEWANEE, IL
ZIP 61443-390
Phone: (309) 853-4325
Fax: (309) 853-4385

The provider's authorized official is William Nelson .
The authorized official title is Ceo and has the following contact phone number (309) 344-2323.

The enumeration date for this NPI number is 4/17/2007 and was last updated on 7/21/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	ILLINOIS	No
2	101YM0800X	Counselor	Mental Health	ILLINOIS	No
3	171M00000X	Case Manager/Care Coordinator		ILLINOIS	No
4	2084P0800X	Psychiatry & Neurology	Psychiatry	ILLINOIS	No
5	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)		Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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