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General NPI Number Information
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NPI Number | 1851350300
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Entity Type | Organization
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Legal Business Name | BRIDGES HEALTHCARE INC.
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Dates
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Enumeration Date | 03/22/2006
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Last Update Date | 02/08/2022
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Provider Practice Location Address
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Address Line | 949 BRIDGEPORT AVE
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City | MILFORD
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State | CT
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Zip | 06460-3142
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Country | US
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Telephone | 203-878-6365
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Fax | 203-301-2397
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Provider Business Mailing Address
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Address Line | 949 BRIDGEPORT AVE
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City | MILFORD
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State | CT
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Zip | 06460-3142
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Country | US
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Telephone | 203-878-6365
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Fax | 203-301-2397
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | MS. JENNIFER FIORILLO
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Credential |
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Telephone | 203-878-6365
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 0313
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 0314
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License Number State | CT
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Taxonomy #3
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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 | C0034
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License Number State | CT
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Taxonomy #4
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 0316
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License Number State | CT
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