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General NPI Number Information
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NPI Number | 1962995993
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Entity Type | Organization
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Legal Business Name | THE BRIDGE HOME FOR CHILDREN
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Dates
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Enumeration Date | 06/13/2018
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Last Update Date | 06/13/2018
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Provider Practice Location Address
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Address Line | 6033 SWOPE PKWY
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City | KANSAS CITY
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State | MO
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Zip | 64130-4461
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Country | US
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Telephone | 816-333-8711
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Fax | 816-333-8799
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Provider Business Mailing Address
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Address Line | 6033 SWOPE PKWY
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City | KANSAS CITY
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State | MO
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Zip | 64130-4461
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Country | US
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Telephone | 816-333-8711
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Fax | 816-333-8799
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. BEVERLY JEAN WATSON
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Credential |
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Telephone | 816-333-8711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number |
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License Number State | MO
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