Healthcare Provider Details

I. General information

NPI: 1972456820
Provider Name (Legal Business Name): THE BRIDGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 WOOD AVE LOT I23
COLORADO SPRINGS CO
80907-5165
US

IV. Provider business mailing address

3100 WOOD AVE LOT I23
COLORADO SPRINGS CO
80907-5165
US

V. Phone/Fax

Practice location:
  • Phone: 719-352-7190
  • Fax:
Mailing address:
  • Phone: 719-352-7190
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name: KELLY POWERS
Title or Position: BILLER
Credential:
Phone: 719-799-0608