BRIDGEWAY HEALTH SERVICES, LLC; NPI #1265703953

Contact Information

BRIDGEWAY HEALTH SERVICES, LLC

1032 S. BRIDGEWAY PL,
STE 110
EAGLE, ID 83616

Phone: 208-475-0800
Fax: 208-639-0901
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Mental Health (Including Community Mental Health Center)	261QM0801X	B4[14]	Community Mental Health Center

Indicates primary specialty

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NPI Profile & details for BRIDGEWAY HEALTH SERVICES, LLC

NPI Number 1265703953

LBN Legal business name BRIDGEWAY HEALTH SERVICES, LLC

Authorized official GRANT BELNAP - (OWNER)

Entity Organization

Organization subpart ¹ No

Enumeration date 01/26/2012

Last updated 01/26/2012 - About 14 years ago

Identifiers

License #

M7357

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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