Bridges to Success, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

BRIDGES TO SUCCESS, INC.

Practice address

104 1/2 West Superior Street
Duluth, MN 55802

Phone

(218) 728-1189

Fax

(218) 722-2325

NPI assigned

Jun 27, 2012

Organization subpart

Yes

Parent organization

AHL HEALTHCARE GROUPAs reported in NPPES

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

Authorized official

Name

Maria Runyan

Title

Executive Director

Phone

(218) 728-1189

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1340755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632441600000",
    "number": "1487918199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16510",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "55816",
            "telephone_number": "218-728-1189",
            "fax_number": "218-722-2325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 1/2 WEST SUPERIOR STREET",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "55802",
            "telephone_number": "218-728-1189",
            "fax_number": "218-722-2325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGES TO SUCCESS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AHL HEALTHCARE GROUP",
        "enumeration_date": "2012-06-27",
        "last_updated": "2021-09-24",
        "certification_date": "2021-09-24",
        "status": "A",
        "authorized_official_last_name": "RUNYAN",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "218-728-1189"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MN",
            "license": "A660083100",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMPI",
            "identifier": "A660083100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Andrew D Broadmoore, MD

• All providers in Duluth, MN
• Community/Behavioral Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2021; 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.