COMMUNITY BRIDGES WEST INC. NPI 1255467031

NPI Information

  • NPI: 1255467031
  • Provider Name: COMMUNITY BRIDGES WEST, INC.
  • Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
  • Entity Type: Organization
  • Doing Business As: JERICHO HOME
  • Address: 2515 BROWNLEE RD
    BOSSIER CITY, LA
    ZIP 71111
  • Phone: (318) 255-9137

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NPI Details

COMMUNITY BRIDGES WEST, INC. is an intermediate care facility mentally retarded in Bossier City, LA. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. COMMUNITY BRIDGES WEST, INC. NPI is 1255467031. The provider is registered as an organization entity type.
The provider Is Doing Business As Jericho Home.

The provider's business location address is:

2515 BROWNLEE RD
BOSSIER CITY, LA
ZIP 71111-011
Phone: (318) 255-9137
Fax: (318) 255-8233

The provider's authorized official is Mike L. Reynolds .
The authorized official title is Ceo and has the following contact phone number (318) 255-9137.

The enumeration date for this NPI number is 2/26/2007 and was last updated on 8/22/2020.

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
1315P00000XIntermediate Care Facility, Intellectual Disabilities896LOUISIANAYes

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
11718441MEDICAIDLOUISIANA

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: 3/30/2025

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