Bridgeway, Inc
Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Macomb, IL
NPI 1124241625 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1124241625
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
- Legal business name
- BRIDGEWAY, INC
- Practice address
- 301 W Calhoun St
Macomb, IL 61455-2154 - Phone
- (309) 836-4172
- NPI assigned
- Apr 11, 2007
- Organization subpart
- No
Authorized official
- Name
- William Nelson
- Title
- Ceo
- Phone
- (309) 344-2323
Corporate family (same tax ID) 14
National Provider Directory
- Tax ID family
- Julio R Lozano MD
Locations
301 W Calhoun St
Macomb, IL 61455
Phone (309) 836-4172
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | IL | Yes | |
| Intellectual Disabilities Intermediate Care Facility | 315P00000X | 022 | IL |
Addresses
Primary practice location
301 W Calhoun St
Macomb, IL 61455-2154
Mailing address
900 S Deer Rd
Macomb, IL 61455-2639
Phone (309) 837-4876
Other providers in Macomb, IL
- Eric Botts
- Amanda Bourdon
- Michelle M Bowen
- Bridgeway Inc
- Bridgeway Inc
- Bridgeway, Inc
- Bridgeway, Inc
- Bridgeway, Inc
- Charnelle Nicole Brinker
- Jessica Britenstine
All providers in Macomb, IL · Mental Health Clinic/Center (Including Community Mental Health Center) in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.