Provider Demographics
NPI:1518762137
Name:BRIDGEPOINT PEER SERVICES
Entity type:Organization
Organization Name:BRIDGEPOINT PEER SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RE'NAE
Authorized Official - Middle Name:LAURA
Authorized Official - Last Name:PHERIGO
Authorized Official - Suffix:
Authorized Official - Credentials:PEER SUPPORT SUPERVI
Authorized Official - Phone:316-452-6217
Mailing Address - Street 1:616 E LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:KS
Mailing Address - Zip Code:67152-3060
Mailing Address - Country:US
Mailing Address - Phone:316-452-6217
Mailing Address - Fax:
Practice Address - Street 1:616 E LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:KS
Practice Address - Zip Code:67152-3060
Practice Address - Country:US
Practice Address - Phone:316-452-6217
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health