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General NPI Number Information
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NPI Number | 1871127787
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Entity Type | Organization
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Legal Business Name | BRIDGECARE HEALTH GROUP LLC
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Dates
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Enumeration Date | 02/29/2020
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Last Update Date | 11/04/2020
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Provider Practice Location Address
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Address Line | 1408 DUDLEY DR
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City | CARROLLTON
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State | TX
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Zip | 75007-2724
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Country | US
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Telephone | 786-525-8597
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Fax |
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Provider Business Mailing Address
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Address Line | 1408 DUDLEY DR
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City | CARROLLTON
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State | TX
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Zip | 75007-2724
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Country | US
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Telephone | 786-525-8597
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ERICA ANDERSON
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Credential |
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Telephone | 305-890-8510
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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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Taxonomy #3
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health 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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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