Provider Demographics
NPI:1164675534
Name:BLUEBRIDGE PROFESSIONAL SERVICES
Entity Type:Organization
Organization Name:BLUEBRIDGE PROFESSIONAL SERVICES
Other - Org Name:COMFORT KEEPERS #237
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CHANTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCREERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-625-6151
Mailing Address - Street 1:420 W BASELINE RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-1621
Mailing Address - Country:US
Mailing Address - Phone:909-625-6151
Mailing Address - Fax:909-625-6153
Practice Address - Street 1:420 W BASELINE RD STE D
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-1621
Practice Address - Country:US
Practice Address - Phone:909-625-6151
Practice Address - Fax:909-625-6153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-29
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care