Provider Demographics
NPI:1659038875
Name:FAMILY BRIDGES INC
Entity Type:Organization
Organization Name:FAMILY BRIDGES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CORINNE
Authorized Official - Middle Name:
Authorized Official - Last Name:JAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-839-2022
Mailing Address - Street 1:168 11TH ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94607-4841
Mailing Address - Country:US
Mailing Address - Phone:510-839-2022
Mailing Address - Fax:
Practice Address - Street 1:275 14TH ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-4070
Practice Address - Country:US
Practice Address - Phone:510-595-5588
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAMILY BRIDGES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-11-22
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251X00000XAgenciesSupports BrokerageGroup - Multi-Specialty