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General NPI Number Information
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NPI Number | 1770405136
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Entity Type | Organization
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Legal Business Name | THE BRIDGE HOUSEHOLD
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Dates
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Enumeration Date | 07/28/2026
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Last Update Date | 07/28/2026
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Provider Practice Location Address
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Address Line | 2109 BAINBRIDGE ST
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City | RICHMOND
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State | VA
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Zip | 23225-3931
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Country | US
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Telephone | 804-750-3468
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 26481
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City | RICHMOND
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State | VA
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Zip | 23261-6481
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Country | US
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Telephone | 804-750-3468
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | TRAVIS D WILKINS
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Credential |
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Telephone | 804-750-3468
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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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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Taxonomy #3
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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