Provider Demographics
NPI:1184479628
Name:BRIDGER RECOVERY PLLC
Entity type:Organization
Organization Name:BRIDGER RECOVERY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:MARK
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:301-956-6820
Mailing Address - Street 1:141 DISCOVERY DR STE 109
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-4134
Mailing Address - Country:US
Mailing Address - Phone:406-518-0625
Mailing Address - Fax:
Practice Address - Street 1:141 DISCOVERY DR STE 109
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-4134
Practice Address - Country:US
Practice Address - Phone:406-518-0625
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-18
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty