Healthcare Provider Details

I. General information

NPI: 1174386049
Provider Name (Legal Business Name): BRIDGE TO INDEPENDENCE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2024
Last Update Date: 02/03/2024
Certification Date: 02/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9012 Q ST
OMAHA NE
68127-3549
US

IV. Provider business mailing address

2234 S 141ST PLZ APT 9
OMAHA NE
68144-2365
US

V. Phone/Fax

Practice location:
  • Phone: 531-600-3779
  • Fax:
Mailing address:
  • Phone: 531-600-3779
  • Fax: 531-247-5557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MCKENZIE SCHNEIDER
Title or Position: PRESIDENT
Credential: OTD, OTR/L
Phone: 425-336-9924