Provider Demographics
NPI:1013395953
Name:BRIDGES ACADEMY CORP
Entity Type:Organization
Organization Name:BRIDGES ACADEMY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCOMBER
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:541-318-9345
Mailing Address - Street 1:67030 GIST RD
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-9209
Mailing Address - Country:US
Mailing Address - Phone:541-318-9345
Mailing Address - Fax:
Practice Address - Street 1:67030 GIST RD
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-9209
Practice Address - Country:US
Practice Address - Phone:541-318-9345
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-12
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children