Healthcare Provider Details

I. General information

NPI: 1134084437
Provider Name (Legal Business Name): BRIDGE POINT RESIDENTIAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

76 E LINCOLN AVE
LONDON OH
43140-1505
US

IV. Provider business mailing address

2225 ARBUCKLE RD NW
LONDON OH
43140-8999
US

V. Phone/Fax

Practice location:
  • Phone: 614-531-1758
  • Fax:
Mailing address:
  • Phone: 614-531-1758
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. ANGELA A NICKELL
Title or Position: CEO/OWNER
Credential:
Phone: 614-531-1758