NPIMap

Organization Active NPI

Bridge Back to Life Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Brooklyn, NY
National Provider Identifier
1881922508
Registry record updated Nov 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
079825-1 Issued in NY
Legal business name
BRIDGE BACK TO LIFE CENTER
Practice address
175 Remsen St
10TH Floor
Brooklyn, NY 11201-4300
Phone
(718) 852-5552
NPI assigned
Nov 19, 2009
Last updated
Nov 19, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2009

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

Authorized official

Name
Betsy J Hamilton, LMSWNPI 1245561430
Title
Social Worker
Phone
(718) 852-5552

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
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 079825-1 NY Primary

Addresses

Primary practice location

175 Remsen St
10TH Floor
Brooklyn, NY 11201-4300

Mailing address

175 Remsen St
10TH Floor
Brooklyn, NY 11201-4300
Phone (718) 852-5552

Other identifiers 1

IdentifierTypeStateIssuer
079825-1OtherNYLMSW

National Provider Directory

National Provider Directory
Tax ID family
Bridge Back to Life Center Inc14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1258588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258588800000",
    "number": "1881922508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 REMSEN ST",
            "address_2": "10TH FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112014300",
            "telephone_number": "718-852-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 REMSEN ST",
            "address_2": "10TH FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112014300",
            "telephone_number": "718-852-5552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGE BACK TO LIFE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-19",
        "last_updated": "2009-11-19",
        "status": "A",
        "authorized_official_last_name": "HAMILTON",
        "authorized_official_first_name": "BETSY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SOCIAL WORKER",
        "authorized_official_telephone_number": "718-852-5552",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NY",
            "license": "079825-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LMSW",
            "identifier": "079825-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2009; 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.