BRIDGEHAVEN INC. NPI 1093823817

NPI Information

NPI: 1093823817
Provider Name: BRIDGEHAVEN, INC.

Other Name: BRIDGEHAVEN MENTAL HEALTH SERVICES

Classification: Clinic/Center - 261QM0850X
Entity Type: Organization

Specialization: Adult Mental Health

Address:
950 S 1ST ST
LOUISVILLE, KY
ZIP 40203
Phone: (502) 585-9444
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BRIDGEHAVEN, INC. is an adult mental health clinic center in Louisville, KY. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. BRIDGEHAVEN, INC. NPI is 1093823817. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Bridgehaven Mental Health Services.

The provider's business location address is:

950 S 1ST ST
LOUISVILLE, KY
ZIP 40203-288
Phone: (502) 585-9444
Fax: (502) 585-9466

The provider's authorized official is Ramona L Johnson .
The authorized official title is President/ceo and has the following contact phone number (502) 585-9444.

The CLIA number assigned to this NPI record is 18D2144836 - other - bhso with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/29/2006 and was last updated on 3/10/2016.

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 Number	License State	Primary
1	101YM0800X	Counselor	Mental Health			No
2	251V00000X	Voluntary or Charitable				No
3	251S00000X	Community/Behavioral Health		800159	KENTUCKY	No
4	261QM0850X	Clinic/Center	Adult Mental Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	7100340960	MEDICAID	KENTUCKY
2	30606099	MEDICAID	KENTUCKY
3	213150000	OTHER	KENTUCKY	MAGELLAN
4	3207	MEDICARE PIN	KENTUCKY
5	318961	OTHER	KENTUCKY	VALUE OPTIONS

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: 4/28/2024

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