Bridge Back To Life Center, Inc.

LBN: Bridge Back To Life Center, Inc.
Bridge Back To Life Center, Inc. is an health care organization with primary practice located at 1688 Victory Blvd , Staten Island NY 10314-3547. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as the primary health care specialty. Bridge Back To Life Center, Inc. can be contacted via phone (718) 447-5700, or through Butchen, Gary via phone (516) 520-6600.

Contact Information

Primary practice address
1688 Victory Blvd Staten Island NY 10314-3547
Phone: (718) 447-5700
Fax: (718) 442-8945
Website:
Map and Directions
Authorized official contact:
Name: Butchen, Gary LCSW-R, SAP
Phone: (516) 520-6600

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 141110677 New York

Profile Details

NPI number 1790102051
LBN Legal business name Bridge Back To Life Center, Inc.
DBA Doing business as
Authorized official Butchen, Gary LCSW-R, SAP
Entity Organization
Organization subpart 1 No
Enumeration date Mar 25th, 2014
Last updated Nov 7th, 2018 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790102051 NPPES
New York MEDICAID 01439087

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