MEDICARE: BRIDGEWAY RECOVERY & REENTRY SUPPORT SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1508724816
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIDGEWAY RECOVERY & REENTRY SUPPORT SERVICES LLC

Provider Business Mailing Address
First Line	:	938 HAMMEL ST
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44306-1945
Country	:	US
Telephone Number	:	330-937-2320
Fax Number	:

Provider Business Practice Location Address
First Line	:	1165 GRANT ST APT 200
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44301-1409
Country	:	US
Telephone Number	:	330-937-2320
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	MICHAEL WATSON
Credential	:
Telephone Number	:	330-937-2320

Provider Enumeration Date	:	01/14/2026
Last Update Date	:	01/14/2026

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