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General NPI Number Information
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NPI Number | 1134084437
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Entity Type | Organization
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Legal Business Name | BRIDGE POINT RESIDENTIAL, LLC
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Dates
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Enumeration Date | 12/18/2025
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Last Update Date | 12/18/2025
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Provider Practice Location Address
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Address Line | 76 E LINCOLN AVE
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City | LONDON
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State | OH
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Zip | 43140-1505
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Country | US
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Telephone | 614-531-1758
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Fax |
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Provider Business Mailing Address
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Address Line | 2225 ARBUCKLE RD NW
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City | LONDON
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State | OH
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Zip | 43140-8999
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Country | US
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Telephone | 614-531-1758
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | MRS. ANGELA A NICKELL
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Credential |
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Telephone | 614-531-1758
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number |
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License Number State |
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