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NPI Code Detail

MEDICARE: BRIDGES PROFESSIONAL TREATMENT SERVICES INC.

MEDICARE: BRIDGES PROFESSIONAL TREATMENT SERVICES 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
1324500000XSubstance Abuse Rehabilitation Facility340041BNCA

General Provider Information

NPI Number : 1730327750
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRIDGES PROFESSIONAL TREATMENT SERVICES INC.
Provider Business Mailing Address
First Line : 1422 28TH STREET
Second Line : SUITE A
City : SACRAMENTO
State : CA
Zip : 95618
Country : US
Telephone Number : 916-450-0700
Fax Number : 916-450-0703
Provider Business Practice Location Address
First Line : 2727 P ST
Second Line :
City : SACRAMENTO
State : CA
Zip : 95816-6403
Country : US
Telephone Number : 916-450-0700
Fax Number : 916-450-0703
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MR. KEN KNUTSON
Credential : CADAC
Telephone Number : 916-747-7848
Provider Enumeration Date : 01/29/2009
Last Update Date : 02/02/2009

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