NPIMap

Organization Active NPI

Bridgeway Rehabilitation Services

  • Substance Abuse Rehabilitation Facility
  • Elizabeth, NJ
National Provider Identifier
1861955684
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
BRIDGEWAY REHABILITATION SERVICES
Doing business as
Bridgeway Rehabilitation Services
Practice address
567 Morris Ave
Elizabeth, NJ 07208-1985
Phone
(908) 355-7200
Fax
(908) 469-6519
NPI assigned
Apr 9, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Authorized official

Name
Mrs. Rosita Jimenez
Title
Revenue Cycle Supervisor
Phone
(908) 469-6517

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

567 Morris Ave
Elizabeth, NJ 07208-1985

Mailing address

615 N Broad St
Elizabeth, NJ 07208-3409
Phone (908) 469-6517

Other identifiers 1

IdentifierTypeStateIssuer
7705409MedicaidNJ

Other names 1

  • BRIDGEWAY REHABILITATION SERVICES Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D2102622Bridgeway Rehabilitation Services567 Morris Avenue, Elizabeth, NJ 07208Certificate of waiverSep 24, 2027

National Provider Directory

National Provider Directory
Tax ID family
Bridgeway Behavioral Health Services21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

Organizations that report the same tax identification number in the National Provider Directory.

View all 20

Locations

567 Morris Ave
Elizabeth, NJ 07208
Phone (908) 355-7200

NPI Registry JSON

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

{
    "created_epoch": "1554768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1861955684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 N BROAD ST",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072083409",
            "telephone_number": "908-469-6517",
            "fax_number": "908-469-6519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "567 MORRIS AVE",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072081985",
            "telephone_number": "908-355-7200",
            "fax_number": "908-469-6519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGEWAY REHABILITATION SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-09",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "JIMENEZ",
        "authorized_official_first_name": "ROSITA",
        "authorized_official_title_or_position": "REVENUE CYCLE SUPERVISOR",
        "authorized_official_telephone_number": "908-469-6517",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7705409",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BRIDGEWAY REHABILITATION SERVICES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elizabeth, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.