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General NPI Number Information
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NPI Number | 1366314361
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Entity Type | Organization
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Legal Business Name | THE BRIDGE INC
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Dates
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Enumeration Date | 09/19/2025
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 1835 COUNTY ROAD C W STE 54
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City | ROSEVILLE
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State | MN
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Zip | 55113-1343
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Country | US
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Telephone | 952-200-1465
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Fax |
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Provider Business Mailing Address
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Address Line | 5405 GARLAND LN N
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City | PLYMOUTH
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State | MN
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Zip | 55446-2413
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ESE A ODIAH
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Credential |
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Telephone | 646-338-2689
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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