Provider Demographics
NPI:1184188641
Name:THE BRIDGE MINISTRY, INC.
Entity Type:Organization
Organization Name:THE BRIDGE MINISTRY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:WASHINGTON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:434-969-2991
Mailing Address - Street 1:3054 DIXIE HILL RD
Mailing Address - Street 2:
Mailing Address - City:BUCKINGHAM
Mailing Address - State:VA
Mailing Address - Zip Code:23921-3017
Mailing Address - Country:US
Mailing Address - Phone:434-969-2991
Mailing Address - Fax:434-969-5159
Practice Address - Street 1:3054 DIXIE HILL RD
Practice Address - Street 2:
Practice Address - City:BUCKINGHAM
Practice Address - State:VA
Practice Address - Zip Code:23921-3017
Practice Address - Country:US
Practice Address - Phone:434-969-2991
Practice Address - Fax:434-969-5159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-29
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility