MEDICARE: VERITY BRIDGE CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251C00000X	Developmentally Disabled Services Day Training Agency
2	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1508705302
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VERITY BRIDGE CARE

Provider Business Mailing Address
First Line	:	4056 W 115TH ST APT 305
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60655-4335
Country	:	US
Telephone Number	:	773-922-5739
Fax Number	:

Provider Business Practice Location Address
First Line	:	4056 W 115TH ST APT 305
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60655-4335
Country	:	US
Telephone Number	:	773-922-5739
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	IBRAHIM WAAEYS
Credential	:
Telephone Number	:	612-581-4992

Provider Enumeration Date	:	03/26/2026
Last Update Date	:	03/26/2026

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Directions to “VERITY BRIDGE CARE ” Practice Location

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