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General NPI Number Information
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NPI Number | 1922717438
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Entity Type | Organization
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Legal Business Name | BRIDGECARE ABA IN LLC
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Dates
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Enumeration Date | 11/23/2022
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Last Update Date | 01/12/2023
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Provider Practice Location Address
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Address Line | 8888 KEYSTONE CROSSINGS SUITE 1300
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City | INDIANAPOLIS
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State | IN
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Zip | 46240
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Country | US
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Telephone | 463-252-4475
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Fax |
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Provider Business Mailing Address
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Address Line | 3600 ROUTE 66 STE 150
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City | NEPTUNE
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State | NJ
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Zip | 07753-2645
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Country | US
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Telephone | 201-676-2579
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Fax |
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Authorized Official
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Title or Position | CO-FOUNDER
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Name | MORDECHAI POMERANTZ
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Credential |
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Telephone | 201-676-2579
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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