Provider Demographics
NPI:1417714403
Name:BRIDGES TO HEALTH INC.
Entity Type:Organization
Organization Name:BRIDGES TO HEALTH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KELLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOCHSTETLER
Authorized Official - Suffix:
Authorized Official - Credentials:BA, MT(ASCP)
Authorized Official - Phone:765-662-7289
Mailing Address - Street 1:119 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IN
Mailing Address - Zip Code:46952-3805
Mailing Address - Country:US
Mailing Address - Phone:765-662-7289
Mailing Address - Fax:765-662-4708
Practice Address - Street 1:119 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46952-3805
Practice Address - Country:US
Practice Address - Phone:765-662-7289
Practice Address - Fax:765-662-4708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care