Organization Active NPI

Bridgeway Therapeutic Services Inc

  • Adult Mental Health Clinic/Center
  • Minneapolis, MN
National Provider Identifier
1659098903
Registry record updated Oct 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
BRIDGEWAY THERAPEUTIC SERVICES INC
Practice address
1200 2ND Ave S FL LL
Minneapolis, MN 55403-2513
Phone
(612) 323-9492
Fax
(612) 314-8958
NPI assigned
Oct 26, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2022

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

Authorized official

Name
Adna Mustafa AbukarNPI 1104543529
Title
President
Phone
(612) 323-9492

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
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

1200 2ND Ave S FL LL
Minneapolis, MN 55403-2513

Mailing address

1200 2ND Ave S FL LL
Minneapolis, MN 55403-2513
Phone (612) 323-9492

National Provider Directory

National Provider Directory

Locations

1200 2nd Ave S
Fl Ll
Minneapolis, MN 55403
Phone (612) 323-9492

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1666742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666742400000",
    "number": "1659098903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 2ND AVE S FL LL",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554032513",
            "telephone_number": "612-323-9492",
            "fax_number": "612-314-8958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 2ND AVE S FL LL",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554032513",
            "telephone_number": "612-323-9492",
            "fax_number": "612-314-8958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGEWAY THERAPEUTIC SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-26",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A",
        "authorized_official_last_name": "ABUKAR",
        "authorized_official_first_name": "ADNA",
        "authorized_official_middle_name": "MUSTAFA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "612-323-9492"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; 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.