Healthcare Provider Details

I. General information

NPI: 1922540145
Provider Name (Legal Business Name): BRIDGING ACCESS TO CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2016
Last Update Date: 01/30/2025
Certification Date: 01/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2261 CHURCH AVE
BROOKLYN NY
11226-3201
US

IV. Provider business mailing address

2261 CHURCH AVE
BROOKLYN NY
11226-3201
US

V. Phone/Fax

Practice location:
  • Phone: 347-505-5117
  • Fax: 718-623-1158
Mailing address:
  • Phone: 347-505-5117
  • Fax: 718-623-1158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. ANA LUISA MANON
Title or Position: DIRECTOR OF REVENUE CYCLE MANAGER
Credential:
Phone: 347-505-5117