NPI 1114781945
Bridge Residential Home LLC
Practice location
- Address
- 7343 W Maldonado Rd, Laveen, AZ 85339-7001
- Phone
- (602) 354-9252
- Mailing address
- PO Box 51382, Phoenix, AZ 85076-1382
Authorised official
- Name
- Wildine Burgess
- Title
- Exec Admin
- Phone
- (602) 354-9252
Registered specialties (5)
Psychiatric Residential Treatment Facility
Primary
Cognitive & Behavioral Psychologist
Addiction Medicine (Psychiatry & Neurology) Physician
Substance Abuse Rehabilitation Facility
Psychiatric/Mental Health Nurse Practitioner
Registry record
- NPI
- 1114781945
- Entity type
- Organization
- NPI issued
- 12 Feb 2024
- Record last updated
- 12 Feb 2024
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.