Provider Demographics
NPI:1770074650
Name:THE BRIDGE OF CENTRAL MA, INC
Entity type:Organization
Organization Name:THE BRIDGE OF CENTRAL MA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VP OF FINANCE AND ADMINIS
Authorized Official - Prefix:
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:
Authorized Official - Last Name:BATTERSBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-755-0333
Mailing Address - Street 1:4 MANN ST
Mailing Address - Street 2:
Mailing Address - City:WORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01602
Mailing Address - Country:US
Mailing Address - Phone:508-755-0333
Mailing Address - Fax:508-755-2191
Practice Address - Street 1:4 MANN ST
Practice Address - Street 2:
Practice Address - City:WORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:01602
Practice Address - Country:US
Practice Address - Phone:508-755-0333
Practice Address - Fax:508-755-2191
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE BRIDGE OF CENTRAL MA, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-05-25
Last Update Date:2018-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health