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General NPI Number Information
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NPI Number | 1932801461
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Entity Type | Organization
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Legal Business Name | BRIDGE CONSULTING SERVICES LLC
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Dates
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Enumeration Date | 03/20/2023
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Last Update Date | 06/07/2023
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Provider Practice Location Address
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Address Line | 1700 NEEDMORE RD
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City | DAYTON
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State | OH
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Zip | 45414-3804
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Country | US
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Telephone | 937-270-4945
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Fax |
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Provider Business Mailing Address
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Address Line | 5224 BELLE ISLE DR
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City | DAYTON
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State | OH
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Zip | 45439-3236
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Country | US
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Telephone | 937-270-4945
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. TERRENCE E WILLIAMS
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Credential | LICDC
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Telephone | 937-270-4945
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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