Healthcare Provider Details

I. General information

NPI: 1952966533
Provider Name (Legal Business Name): BRIDGES COMMUNITY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2019
Last Update Date: 01/02/2024
Certification Date: 01/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 29TH ST STE 115
WEST DES MOINES IA
50266-1309
US

IV. Provider business mailing address

1441 29TH ST STE 115
WEST DES MOINES IA
50266-1309
US

V. Phone/Fax

Practice location:
  • Phone: 515-537-1065
  • Fax:
Mailing address:
  • Phone: 515-537-1065
  • Fax: 515-523-8130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name: HAYLEY HOME VENARD
Title or Position: DIRECTOR
Credential:
Phone: 515-537-1065