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General NPI Number Information
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NPI Number | 1033262860
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Entity Type | Organization
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Legal Business Name | BRIDGEWELL, INC
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 35 MARKET ST
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City | LOWELL
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State | MA
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Zip | 01852
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Country | US
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Telephone | 978-459-0389
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Fax | 978-459-7642
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Provider Business Mailing Address
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Address Line | 471 BROADWAY
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City | LYNNFIELD
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State | MA
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Zip | 01940
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Country | US
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Telephone | 339-883-2166
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Fax | 339-883-2187
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | LYNN M LEWIS
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Credential |
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Telephone | 339-883-2166
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 4463
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License Number State | MA
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