NPIMap

Organization Active NPI

Bridge Back to Life

  • Substance Use Disorder Rehabilitation Clinic/Center
  • New York, NY
National Provider Identifier
1083942411
Registry record updated Nov 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
17584 Issued in NY
Legal business name
BRIDGE BACK TO LIFE
Practice address
500 8TH Ave RM 906
New York, NY 10018-4190
Phone
(212) 679-4960
NPI assigned
Nov 23, 2009
Last updated
Nov 23, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Robert J. Vigil, CASACNPI 1952632119
Title
Counselor
Phone
(212) 679-4960

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 17584 NY Primary

Addresses

Primary practice location

500 8TH Ave RM 906
New York, NY 10018-4190

Mailing address

500 8TH Ave RM 906
New York, NY 10018-4190
Phone (212) 679-4960

Other identifiers 1

IdentifierTypeStateIssuer
17584OtherNYCASAC

National Provider Directory

National Provider Directory
Tax ID family
Bridge Back to Life Center Inc14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1258934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258934400000",
    "number": "1083942411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 8TH AVE RM 906",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100184190",
            "telephone_number": "212-679-4960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 8TH AVE RM 906",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100184190",
            "telephone_number": "212-679-4960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGE BACK TO LIFE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-23",
        "last_updated": "2009-11-23",
        "status": "A",
        "authorized_official_last_name": "VIGIL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "COUNSELOR",
        "authorized_official_telephone_number": "212-679-4960",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CASAC"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NY",
            "license": "17584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CASAC",
            "identifier": "17584",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.