Healthcare Provider Details

I. General information

NPI: 1447733076
Provider Name (Legal Business Name): BRIDGE WISE SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2018
Last Update Date: 09/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 ELLIOTT ST
DANVERS MA
01923-3415
US

IV. Provider business mailing address

116 ELLIOTT ST
DANVERS MA
01923-3415
US

V. Phone/Fax

Practice location:
  • Phone: 781-595-2359
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: MISS CAROLINE KAIGAI
Title or Position: MANAGER
Credential:
Phone: 781-595-2359