Healthcare Provider Details
I. General information
NPI: 1629289582
Provider Name (Legal Business Name): BRIDGES TO INDEPENDENCE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/24/2007
Last Update Date: 09/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
61 W WILLIAM ST
DELAWARE OH
43015-2338
US
IV. Provider business mailing address
61 W WILLIAM ST
DELAWARE OH
43015-2338
US
V. Phone/Fax
- Phone: 740-362-1996
- Fax: 740-362-1997
- Phone: 740-362-1996
- Fax: 740-362-1997
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251C00000X |
| Taxonomy | Developmentally Disabled Services Day Training Agency |
| License Number | 5100349 |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 347C00000X |
| Taxonomy | Private Vehicle |
| License Number | 5100349 |
| License Number State | OH |
VIII. Authorized Official
Name: MS.
CHRIS
RITCHIE
Title or Position: PRESIDENT
Credential:
Phone: 740-362-1996