Active NPI
Bridges of Hope LLC
- Substance Abuse Rehabilitation Facility
- Anderson, IN
National Provider Identifier
1447701230
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Substance Abuse Rehabilitation Facility
- Legal business name
- BRIDGES OF HOPE LLC
- Practice address
- 2200 Madison SQ
Anderson, IN 46011-9548 - Phone
- (765) 643-0121
- Fax
- (765) 643-0130
- NPI assigned
- Oct 17, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Carl Waterman
- Title
- Ceo
- Phone
- (765) 643-0121
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Substance Abuse Rehabilitation Facility | 324500000X | Primary |
Addresses
Primary practice location
2200 Madison SQ
Anderson, IN 46011-9548
Mailing address
2200 Madison SQ
Anderson, IN 46011-9548
Phone (765) 643-0121
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300006987 | Other | IN | GROUP MEDICAID |
| IN3606 | Other | IN | GROUP MEDICARE |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Austin, IN
- NPI 1699749770
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1476662400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1683072000000",
"number": "1447701230",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2200 MADISON SQ",
"city": "ANDERSON",
"state": "IN",
"postal_code": "460119548",
"telephone_number": "765-643-0121",
"fax_number": "765-643-0130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2200 MADISON SQ",
"city": "ANDERSON",
"state": "IN",
"postal_code": "460119548",
"telephone_number": "765-643-0121",
"fax_number": "765-643-0130"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BRIDGES OF HOPE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2016-10-17",
"last_updated": "2023-05-03",
"certification_date": "2023-05-03",
"status": "A",
"authorized_official_last_name": "WATERMAN",
"authorized_official_first_name": "CARL",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "765-643-0121"
},
"taxonomies": [
{
"code": "324500000X",
"taxonomy_group": "",
"desc": "Substance Abuse Rehabilitation Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP MEDICAID",
"identifier": "300006987",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP MEDICARE",
"identifier": "IN3606",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Anderson, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.