Provider Demographics
NPI:1619204070
Name:MM UNLIMITED INC.
Entity Type:Organization
Organization Name:MM UNLIMITED INC.
Other - Org Name:BRIDGES RECOVERY NETWORK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROGRAM ADMINSTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:S
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-421-1184
Mailing Address - Street 1:3811 FLORIN RD
Mailing Address - Street 2:SUITE 26
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-1800
Mailing Address - Country:US
Mailing Address - Phone:916-421-1184
Mailing Address - Fax:916-421-1188
Practice Address - Street 1:2350 NORTHROP AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-7222
Practice Address - Country:US
Practice Address - Phone:916-421-1184
Practice Address - Fax:916-421-1188
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MM UNLIMITED INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-11-05
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA343471Medicaid