BRIDGING THE TYS TO JORDAN INC; NPI #1083884019

Contact Information

BRIDGING THE TYS TO JORDAN INC

5500 S INDIANA AVE BSMT
CHICAGO, IL 60637-1011

Phone: 773-425-8159
Fax: 773-488-9462
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)	261QR0401X	B4[14]	Comprehensive Outpatient Rehabilitation Facility
Case Management	251B00000X
Community/Behavioral Health	251S00000X
Rehabilitation, Substance Use Disorder	261QR0405X
Rehabilitation, Substance Use Disorder Unit	276400000X
Substance Abuse Disorder Rehabilitation Facility	324500000X

Indicates primary specialty

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NPI Profile & details for BRIDGING THE TYS TO JORDAN INC

NPI Number 1083884019

LBN Legal business name BRIDGING THE TYS TO JORDAN INC

Authorized official TYSON EVERETT - (EXECUTIVE DIRECTOR)

Entity Organization

Organization subpart ¹ No

Enumeration date 03/05/2008

Last updated 10/22/2025 - About 7 months ago

Identifiers

License #

A-3249-0001

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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