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NPI Code Detail

MEDICARE: BRIDGE HOUSE CORPORATION

MEDICARE: BRIDGE HOUSE CORPORATION
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
1324500000XSubstance Abuse Rehabilitation Facility057-CLA

General Provider Information

NPI Number : 1801168109
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRIDGE HOUSE CORPORATION
Provider Business Mailing Address
First Line : 4150 EARHART BLVD
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70125-1955
Country : US
Telephone Number : 504-821-7122
Fax Number : 504-827-8747
Provider Business Practice Location Address
First Line : 6311 STRATFORD PL
Second Line : BLDG. D
City : NEW ORLEANS
State : LA
Zip : 70131-7325
Country : US
Telephone Number : 504-522-4475
Fax Number : 504-827-8747
Authorized Official
Title or Position : CEO
Name : MRS. ELSE PEDERSEN WASSON
Credential : MBA
Telephone Number : 504-821-7123
Provider Enumeration Date : 02/01/2012
Last Update Date : 06/14/2019

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Directions to “BRIDGE HOUSE CORPORATION ” Practice Location

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