=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184532343
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BRIDGE TO RECOVERY OUTREACH & TRANSPORTATION INITIATIVE, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/31/2026
-----------------------------------------------------
Last Update Date | 08/31/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 254 PROVIDENCE ST
-----------------------------------------------------
City | WORCESTER
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01607-1130
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 774-486-8679
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 254 PROVIDENCE ST
-----------------------------------------------------
City | WORCESTER
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01607-1130
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 774-486-8679
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT AND EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | MR. WILLIAM DIAZ
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 774-486-8679
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 343900000X
-----------------------------------------------------
Taxonomy Name | Non-emergency Medical Transport (VAN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------