Provider Demographics
NPI:1598538472
Name:BRIDGECARE ABA NC LLC
Entity Type:Organization
Organization Name:BRIDGECARE ABA NC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:POMERANTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-676-2579
Mailing Address - Street 1:3600 STATE ROUTE 66 STE 150
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-2645
Mailing Address - Country:US
Mailing Address - Phone:201-676-2579
Mailing Address - Fax:
Practice Address - Street 1:5000 CENTRE GREEN WAY STE 500
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-5821
Practice Address - Country:US
Practice Address - Phone:201-676-2579
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-02
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty