Provider Demographics
NPI:1033730957
Name:BRIDGES COUNSELING AND FAMILY SERVICES CENTER, LLC
Entity Type:Organization
Organization Name:BRIDGES COUNSELING AND FAMILY SERVICES CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MISS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:YVONNE
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:812-954-5121
Mailing Address - Street 1:325 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IN
Mailing Address - Zip Code:47001-1536
Mailing Address - Country:US
Mailing Address - Phone:812-954-5121
Mailing Address - Fax:812-655-3631
Practice Address - Street 1:325 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IN
Practice Address - Zip Code:47001-1536
Practice Address - Country:US
Practice Address - Phone:812-954-5121
Practice Address - Fax:812-655-3631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-01
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)