Healthcare Provider Details

I. General information

NPI: 1477060184
Provider Name (Legal Business Name): BRIDGES ADULT DAY HEALTH CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

352 BEVERLY RANCOCAS RD
WILLINGBORO NJ
08046-3439
US

IV. Provider business mailing address

41 N 3RD ST
PHILADELPHIA PA
19106-4508
US

V. Phone/Fax

Practice location:
  • Phone: 609-871-8881
  • Fax: 609-871-2590
Mailing address:
  • Phone: 215-925-5158
  • Fax: 215-925-6055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SUSAN J VERNACCHIO
Title or Position: CONTROLLER
Credential:
Phone: 215-925-5158