Healthcare Provider Details

I. General information

NPI: 1528560034
Provider Name (Legal Business Name): BRIDGE GROUP INTEGRATED HEALTH CARE SYSTEMS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2018
Last Update Date: 03/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 W BROADWAY RD STE 3
TEMPE AZ
85282-1023
US

IV. Provider business mailing address

1800 W BROADWAY RD STE 3
TEMPE AZ
85282-1023
US

V. Phone/Fax

Practice location:
  • Phone: 480-709-1431
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: ALMA DELIA SALDANA-ESPITIA
Title or Position: BUSINESS MANAGER
Credential:
Phone: 480-709-1431