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General NPI Number Information
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NPI Number | 1295416238
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Entity Type | Organization
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Legal Business Name | BRIDGES TO VETERANS
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Dates
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Enumeration Date | 07/31/2023
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Last Update Date | 07/31/2023
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Provider Practice Location Address
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Address Line | 108 WASHINGTON ST
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City | HOLLY
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State | MI
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Zip | 48442-1659
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Country | US
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Telephone | 248-912-2359
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Fax |
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Provider Business Mailing Address
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Address Line | 108 WASHINGTON ST
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City | HOLLY
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State | MI
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Zip | 48442-1659
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Country | US
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Telephone | 248-912-2359
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Fax |
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Authorized Official
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Title or Position | CHAIRMAN OF THE BOARD
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Name | BRUCE JOHNSON
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Credential | LMSW
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Telephone | 248-912-2359
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 276400000X
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Taxonomy Name | Substance Use Disorder Rehabilitation Hospital Unit
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License Number |
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License Number State |
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