Provider Demographics
NPI:1346594306
Name:THE B..R.I.D.G.E. GROUP
Entity Type:Organization
Organization Name:THE B..R.I.D.G.E. GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GENE
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMBRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-377-4879
Mailing Address - Street 1:2705 SWISS AVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-5923
Mailing Address - Country:US
Mailing Address - Phone:214-377-4879
Mailing Address - Fax:
Practice Address - Street 1:2705 SWISS AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-5923
Practice Address - Country:US
Practice Address - Phone:214-377-4879
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-30
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX453297549101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty