Provider Demographics
NPI:1851516488
Name:BRIDGES TO A NEW DAY,NFP
Entity Type:Organization
Organization Name:BRIDGES TO A NEW DAY,NFP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:S
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC, CDVP
Authorized Official - Phone:815-838-2690
Mailing Address - Street 1:1135 E 9TH ST
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:IL
Mailing Address - Zip Code:60441-3219
Mailing Address - Country:US
Mailing Address - Phone:815-838-2690
Mailing Address - Fax:815-838-2692
Practice Address - Street 1:1135 E 9TH ST
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:IL
Practice Address - Zip Code:60441-3219
Practice Address - Country:US
Practice Address - Phone:815-838-2690
Practice Address - Fax:815-838-2692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health