Bridgeway, Inc
Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Macomb, IL
NPI 1881817385 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1881817385
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
- Legal business name
- BRIDGEWAY, INC
- Practice address
- 7 Pollock Dr
Macomb, IL 61455-1216 - Phone
- (309) 833-5737
- NPI assigned
- Apr 11, 2007
- Organization subpart
- No
Authorized official
- Name
- William Nelson
- Title
- Ceo
- Phone
- (309) 344-2323
Other NPIs on the same Medicare enrollment 15
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050126000609 | IL | Part B Supplier - Clinic/Group Practice | 4284627530 |
Receives reassigned benefits from 9 practitioners 15 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Macomb, IL; Moline, IL; Monmouth, IL; Normal, IL; North Pekin, IL; Pekin, IL; Kewanee, IL; Loves Park, IL… |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | Yes | ||
| Intellectual Disabilities Intermediate Care Facility | 315P00000X | 025 | IL |
Addresses
Primary practice location
7 Pollock Dr
Macomb, IL 61455-1216
Mailing address
2323 Windish Dr
Galesburg, IL 61401-9780
Phone (309) 344-4208
Other providers in Macomb, IL
- Michelle M Bowen
- Bridgeway Inc
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- Bridgeway, Inc
- Charnelle Nicole Brinker
- Jessica Britenstine
- Jill Marie Brody
- Bruenger Chiropractic LLC
All providers in Macomb, IL · Mental Health Clinic/Center (Including Community Mental Health Center) in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.