Provider Demographics
NPI:1689360828
Name:BRIDGES FORWARD, LLC
Entity Type:Organization
Organization Name:BRIDGES FORWARD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TINNIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-416-6270
Mailing Address - Street 1:7 W 49TH AVE
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99337-4446
Mailing Address - Country:US
Mailing Address - Phone:509-416-6270
Mailing Address - Fax:509-343-2958
Practice Address - Street 1:7 W 49TH AVE
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99337-4446
Practice Address - Country:US
Practice Address - Phone:509-416-6270
Practice Address - Fax:509-343-2958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-12
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty