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BRIDGEWAY PSYCHIATRIC CENTER INC. NPI 1366433278


NPI Information

NPI: 1366433278
Provider Name: BRIDGEWAY PSYCHIATRIC CENTER, INC.
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

CLIA Number: 19D2120018

Address:
3451 5TH AVE
SUITE A
LAKE CHARLES, LA
ZIP 70607
Phone: (337) 562-0211
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BRIDGEWAY PSYCHIATRIC CENTER, INC. is a mental health (including community mental health center) clinic center in Lake Charles, LA. BRIDGEWAY PSYCHIATRIC CENTER, INC. NPI is 1366433278. The provider is registered as an organization entity type.

The provider's business location address is:

3451 5TH AVE
SUITE A
LAKE CHARLES, LA
ZIP 70607-127
Phone: (337) 562-0211
Fax: (337) 562-0212

The provider's authorized official is Anne Dill .
The authorized official title is Regional Director and has the following contact phone number (337) 785-8003.

The CLIA number assigned to this NPI record is 19D2120018 - other - psych hospital hopd with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/31/2005 and was last updated on 4/30/2010.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
161404OTHERLOUISIANABLUE CROSS BLUE SHIELD
2194690MEDICARE ID-TYPE UNSPECIFIEDLOUISIANA
31152013MEDICAIDLOUISIANA

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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