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General NPI Number Information
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NPI Number | 1740085604
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Entity Type | Organization
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Legal Business Name | BRIDGEPOINT PEER SOLUTIONS
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Dates
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Enumeration Date | 02/15/2025
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Last Update Date | 02/15/2025
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Provider Practice Location Address
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Address Line | 616 E LINCOLN AVE
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City | WELLINGTON
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State | KS
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Zip | 67152-3060
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Country | US
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Telephone | 316-452-6217
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Fax |
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Provider Business Mailing Address
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Address Line | 616 E LINCOLN AVE
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City | WELLINGTON
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State | KS
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Zip | 67152-3060
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Country | US
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Telephone | 316-452-6217
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | MRS. RE'NAE LAURA PHERIGO
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Credential |
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Telephone | 316-452-6217
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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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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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