BRIDGE BACK TO LIFE INC. NPI 1811228687

NPI Information

NPI: 1811228687
Provider Name: BRIDGE BACK TO LIFE, INC.
Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

Address:
1688 VICTORY BLVD
STATEN ISLAND, NY
ZIP 10314
Phone: (718) 447-5700
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BRIDGE BACK TO LIFE, INC. is a rehabilitation and substance use disorder clinic center in Staten Island, NY. BRIDGE BACK TO LIFE, INC. NPI is 1811228687. The provider is registered as an organization entity type.

The provider's business location address is:

1688 VICTORY BLVD
STATEN ISLAND, NY
ZIP 10314-533
Phone: (718) 447-5700

The provider's authorized official is Kathryn Marie Ryan .
The authorized official title is Staff Therapist and has the following contact phone number (718) 447-5700.

The enumeration date for this NPI number is 1/19/2010 and was last updated on 1/19/2010.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder	080531	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	080531	OTHER	NEW YORK	KATHRYN MARIE RYAN

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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