Provider Demographics
NPI:1073984795
Name:THE BRIDGE, INC.
Entity Type:Organization
Organization Name:THE BRIDGE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCHWARCZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-228-3000
Mailing Address - Street 1:860 BLOOMFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:WEST CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006-7106
Mailing Address - Country:US
Mailing Address - Phone:973-228-3000
Mailing Address - Fax:973-228-2742
Practice Address - Street 1:860 BLOOMFIELD AVE
Practice Address - Street 2:
Practice Address - City:WEST CALDWELL
Practice Address - State:NJ
Practice Address - Zip Code:07006-7106
Practice Address - Country:US
Practice Address - Phone:973-228-3000
Practice Address - Fax:973-228-2742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-08
Last Update Date:2018-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ100460104261QM0801X
NJ2000144261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0470325Medicaid