Bridgeway Residential Services

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

1366 Issued in VA

Legal business name

BRIDGEWAY RESIDENTIAL SERVICES

Practice address

5118 Bridgeside Dr
North Chesterfield, VA 23234-2860

Phone

(804) 301-2984

Fax

(804) 279-0736

NPI assigned

Jun 6, 2012

Organization subpart

No

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

Authorized official

Name

Ms. Deninez Moss

Title

Program Director

Phone

(804) 301-2984

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1338940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338940800000",
    "number": "1578824538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5118 BRIDGESIDE DR",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232342860",
            "telephone_number": "804-301-2984",
            "fax_number": "804-279-0736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5118 BRIDGESIDE DR",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232342860",
            "telephone_number": "804-301-2984",
            "fax_number": "804-279-0736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGEWAY RESIDENTIAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-06",
        "last_updated": "2012-06-06",
        "status": "A",
        "authorized_official_last_name": "MOSS",
        "authorized_official_first_name": "DENINEZ",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "804-301-2984",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "VA",
            "license": "1366",
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "VA",
            "license": "1366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in North Chesterfield, VA
• Providers in North Chesterfield, VA by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2012; 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.