Provider Demographics
NPI:1235461252
Name:BRIDGE OF HOPE, INC
Entity Type:Organization
Organization Name:BRIDGE OF HOPE, INC
Other - Org Name:BRIDGE OF HOPE ADULT DAY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHARLYE
Authorized Official - Middle Name:J
Authorized Official - Last Name:VANCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-430-3144
Mailing Address - Street 1:PO BOX 26036
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46226-0036
Mailing Address - Country:US
Mailing Address - Phone:317-430-3144
Mailing Address - Fax:
Practice Address - Street 1:2511 E 46TH ST
Practice Address - Street 2:SUITE E - 1
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46205-2460
Practice Address - Country:US
Practice Address - Phone:317-430-3144
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-01
Last Update Date:2010-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200962360AOtherLPI