Provider Demographics
NPI:1366506594
Name:BRIDGES INC FOR ELDER CARE
Entity Type:Organization
Organization Name:BRIDGES INC FOR ELDER CARE
Other - Org Name:R I E C
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KOLYNO
Authorized Official - Suffix:
Authorized Official - Credentials:HSS
Authorized Official - Phone:423-339-8920
Mailing Address - Street 1:POB 4924
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37320
Mailing Address - Country:US
Mailing Address - Phone:866-353-3755
Mailing Address - Fax:423-339-8970
Practice Address - Street 1:1819 FOREST RIDGE DRIVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37311
Practice Address - Country:US
Practice Address - Phone:186-635-3375
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN251B00000X, 251X00000X
251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251B00000XAgenciesCase Management
Not Answered251V00000XAgenciesVoluntary or Charitable
Not Answered251X00000XAgenciesSupports Brokerage
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherNON PROFIT TN