Bridge Residential Home Llc

LBN: Bridge Residential Home Llc
Bridge Residential Home Llc is an health care organization with primary practice located at 7343 W Maldonado Rd , Laveen AZ 85339-7001. The organization recently has 5 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Cognitive & Behavioral, Allopathic & Osteopathic Physicians / Addiction Medicine, Residential Treatment Facilities / Psychiatric Residential Treatment Facility, Residential Treatment Facilities / Substance Abuse Rehabilitation Facility, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Residential Treatment Facilities / Psychiatric Residential Treatment Facility is the primary health care specialty. Bridge Residential Home Llc can be contacted via phone (602) 354-9252, or through Burgess, Wildine via phone (602) 354-9252.

Contact Information

Primary practice address
7343 W Maldonado Rd Laveen AZ 85339-7001
Phone: (602) 354-9252
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Burgess, Wildine
Phone: (602) 354-9252

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Cognitive & Behavioral 103TB0200X
Allopathic & Osteopathic Physicians / Addiction Medicine 2084A0401X
Residential Treatment Facilities / Psychiatric Residential Treatment Facility 323P00000X
Residential Treatment Facilities / Substance Abuse Rehabilitation Facility 324500000X
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X

Profile Details

NPI number 1114781945
LBN Legal business name Bridge Residential Home Llc
DBA Doing business as
Authorized official Burgess, Wildine
Entity Organization
Organization subpart 1 No
Enumeration date Feb 12th, 2024
Last updated Feb 12th, 2024 - about 10 months 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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