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General NPI Number Information
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NPI Number | 1972648988
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Entity Type | Organization
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Legal Business Name | BRIDGEWAY, INC.
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8301 DETROIT AVE
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City | CLEVELAND
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State | OH
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Zip | 44102-1805
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Country | US
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Telephone | 216-281-2660
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Fax | 216-281-5183
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Provider Business Mailing Address
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Address Line | 8301 DETROIT AVE
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City | CLEVELAND
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State | OH
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Zip | 44102-1805
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Country | US
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Telephone | 216-281-2660
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Fax | 216-281-5183
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Authorized Official
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Title or Position | CFO
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Name | MR. MICHAEL J KRAFCIK
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Credential | CPA
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Telephone | 216-688-4130
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | OH
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