Provider Demographics
NPI:1508489352
Name:THE BRIDGE, INC.
Entity Type:Organization
Organization Name:THE BRIDGE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLER
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:ELENA
Authorized Official - Last Name:PAYEUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-228-3000
Mailing Address - Street 1:860 BLOOMFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:WEST CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006-7106
Mailing Address - Country:US
Mailing Address - Phone:973-228-3000
Mailing Address - Fax:
Practice Address - Street 1:860 BLOOMFIELD AVE
Practice Address - Street 2:
Practice Address - City:WEST CALDWELL
Practice Address - State:NJ
Practice Address - Zip Code:07006-7106
Practice Address - Country:US
Practice Address - Phone:973-228-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-27
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder