Provider Demographics
NPI:1396543369
Name:BRIDGES BEHAVIORAL, L.L.C.
Entity type:Organization
Organization Name:BRIDGES BEHAVIORAL, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:L
Authorized Official - Last Name:DADDS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSWC
Authorized Official - Phone:410-708-7626
Mailing Address - Street 1:207 N LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21617-1189
Mailing Address - Country:US
Mailing Address - Phone:410-708-7626
Mailing Address - Fax:
Practice Address - Street 1:207 N LIBERTY ST
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:MD
Practice Address - Zip Code:21617-1189
Practice Address - Country:US
Practice Address - Phone:410-708-7626
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Multi-Specialty