MEDICARE: THE BRIDGE, INC

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1710937693
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE BRIDGE, INC

Provider Business Mailing Address
First Line	:	3232 LAY SPRINGS RD
Second Line	:
City	:	GADSDEN
State	:	AL
Zip	:	35904-8611
Country	:	US
Telephone Number	:	256-546-6324
Fax Number	:	256-456-0023

Provider Business Practice Location Address
First Line	:	3232 LAY SPRINGS RD
Second Line	:
City	:	GADSDEN
State	:	AL
Zip	:	35904-8611
Country	:	US
Telephone Number	:	256-546-6324
Fax Number	:	256-456-0023

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. TIM NAUGHER
Credential	:
Telephone Number	:	256-546-6324

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	08/22/2020

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Directions to “THE BRIDGE, INC ” Practice Location

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