Provider Demographics
NPI:1043470362
Name:BRIDGES CARE CENTER
Entity Type:Organization
Organization Name:BRIDGES CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BIENEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-784-5250
Mailing Address - Street 1:201 9TH ST W
Mailing Address - Street 2:SUITE #2
Mailing Address - City:ADA
Mailing Address - State:MN
Mailing Address - Zip Code:56510-1243
Mailing Address - Country:US
Mailing Address - Phone:218-784-5500
Mailing Address - Fax:218-784-5574
Practice Address - Street 1:201 9TH ST W
Practice Address - Street 2:SUITE #2
Practice Address - City:ADA
Practice Address - State:MN
Practice Address - Zip Code:56510-1243
Practice Address - Country:US
Practice Address - Phone:218-784-5500
Practice Address - Fax:218-784-5574
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BENEDICTINE HEALTH SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-10
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN310400000X
314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN245502Medicare Oscar/Certification