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General NPI Number Information
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NPI Number | 1174077325
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Entity Type | Organization
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Legal Business Name | BRIDGE AGENCY INC
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Dates
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Enumeration Date | 08/04/2016
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Last Update Date | 12/12/2023
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Provider Practice Location Address
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Address Line | 400 S FARRELL DR SUITE B100
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City | PALM SPRINGS
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State | CA
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Zip | 92262-7964
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Country | US
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Telephone | 760-904-4209
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Fax | 760-904-4189
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Provider Business Mailing Address
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Address Line | 400 S FARRELL DR SUITE B100
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City | PALM SPRINGS
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State | CA
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Zip | 92262-7964
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Country | US
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Telephone | 760-318-0554
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Fax | 760-904-4189
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Authorized Official
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Title or Position | CEO/CFO/ADMINISTRATOR
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Name | LEONARD WILLIAMS
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Credential |
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Telephone | 760-318-0554
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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