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NPI Code Detail

MEDICARE: BRIDGES COMM TREATMENT SVS.INC.

MEDICARE: BRIDGES COMM TREATMENT SVS.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
1251B00000XCase Management Agency

General Provider Information

NPI Number : 1952589384
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRIDGES COMM TREATMENT SVS.INC.
Provider Business Mailing Address
First Line : 279 E ARROW HWY
Second Line : 102
City : SAN DIMAS
State : CA
Zip : 91773-3319
Country : US
Telephone Number : 909-623-6651
Fax Number : 909-623-0455
Provider Business Practice Location Address
First Line : 1515 W CAMERON AVE STE 310
Second Line :
City : WEST COVINA
State : CA
Zip : 91790-2726
Country : US
Telephone Number : 626-350-5304
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : LORI PENDROFF
Credential :
Telephone Number : 909-623-6651
Provider Enumeration Date : 02/07/2008
Last Update Date : 12/13/2024

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