BRIDGE BACK TO LIFE CENTER NPI 1629306055

NPI Information

NPI: 1629306055
Provider Name: BRIDGE BACK TO LIFE CENTER
Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

Address:
500 8TH AVE RM 906
NEW YORK, NY
ZIP 10018
Phone: (212) 679-4960
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BRIDGE BACK TO LIFE CENTER is a rehabilitation and substance use disorder clinic center in New York, NY. BRIDGE BACK TO LIFE CENTER NPI is 1629306055. The provider is registered as an organization entity type.

The provider's business location address is:

500 8TH AVE RM 906
NEW YORK, NY
ZIP 10018-190
Phone: (212) 679-4960

The provider's authorized official is George Pagan .
The authorized official title is Counselor and has the following contact phone number (212) 679-4960.

The enumeration date for this NPI number is 11/23/2009 and was last updated on 11/23/2009.

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	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder	5542	NEW YORK	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	5542	OTHER	NEW YORK	CASAC

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

NPI Synchronization or Removal

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