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General NPI Number Information
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NPI Number | 1770046211
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Entity Type | Organization
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Legal Business Name | BRIDGEWATER OPCO, LLC
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Dates
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Enumeration Date | 04/11/2019
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Last Update Date | 02/17/2025
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Provider Practice Location Address
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Address Line | 390 ROUTE 22 EAST
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City | BRIDGEWATER
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State | NJ
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Zip | 08807-2478
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Country | US
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Telephone | 908-605-2074
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Fax | 908-605-2075
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Provider Business Mailing Address
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Address Line | 390 ROUTE 22 EAST
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City | BRIDGEWATER
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State | NJ
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Zip | 08807-2478
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Country | US
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Telephone | 908-605-2074
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Fax | 908-605-2075
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Authorized Official
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Title or Position | SENIOR REIMBURSEMENT MANAGER
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Name | MR. TONY J. HARRIS
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Credential |
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Telephone | 703-854-0830
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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