Provider Demographics
NPI:1922231547
Name:THE BRIDGES COUNCIL, INC
Entity Type:Organization
Organization Name:THE BRIDGES COUNCIL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPUTY DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:BURLISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-514-8933
Mailing Address - Street 1:5576 IDLE CREEK LN
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47802-8181
Mailing Address - Country:US
Mailing Address - Phone:812-514-8933
Mailing Address - Fax:812-514-8933
Practice Address - Street 1:5576 IDLE CREEK LN
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802-8181
Practice Address - Country:US
Practice Address - Phone:812-514-8933
Practice Address - Fax:812-514-8933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-30
Last Update Date:2009-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care