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General NPI Number Information
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NPI Number | 1093249542
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Entity Type | Organization
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Legal Business Name | BRIDGES COMMUNITY HEALTH INC.
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Dates
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Enumeration Date | 04/11/2017
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 1450 BIRCH AVE
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City | COTTAGE GROVE
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State | OR
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Zip | 97424-1417
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Country | US
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Telephone | 541-255-1411
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Fax | 541-255-1412
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Provider Business Mailing Address
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Address Line | 1976 GARDEN AVE
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City | EUGENE
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State | OR
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Zip | 97403-1933
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Country | US
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Telephone | 541-255-1411
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Fax | 541-255-1412
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Authorized Official
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Title or Position | MANAGER
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Name | TRACEY KENYON
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Credential |
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Telephone | 541-255-1411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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