Provider Demographics
NPI:1235744897
Name:BRIDGES TRAINING FOUNDATION
Entity Type:Organization
Organization Name:BRIDGES TRAINING FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-672-6902
Mailing Address - Street 1:110 E OHIO AVE
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:TX
Mailing Address - Zip Code:76065-2730
Mailing Address - Country:US
Mailing Address - Phone:469-672-6902
Mailing Address - Fax:
Practice Address - Street 1:110 E OHIO AVE
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:TX
Practice Address - Zip Code:76065-2730
Practice Address - Country:US
Practice Address - Phone:469-672-6902
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-10
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities