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General NPI Number Information
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NPI Number | 1285025452
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Entity Type | Organization
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Legal Business Name | BRIDGEWAY BEHAVIORAL HEALTH SERVICES
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Dates
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Enumeration Date | 02/10/2015
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Last Update Date | 06/27/2025
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Provider Practice Location Address
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Address Line | 4 PRINCESS RD SUITE 205B
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City | LAWRENCEVILLE
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State | NJ
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Zip | 08648-2322
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Country | US
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Telephone | 609-512-1372
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Fax | 609-512-1723
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Provider Business Mailing Address
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Address Line | 615 N BROAD ST
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City | ELIZABETH
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State | NJ
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Zip | 07208-3409
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Country | US
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Telephone | 908-355-7886
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Fax | 908-355-6668
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Authorized Official
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Title or Position | DIRECTOR OF BILLING AND REIMBURSEME
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Name | FRED OLMSTED
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Credential |
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Telephone | 848-304-2436
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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