Bridge Back To Life Center, Inc.
LBN: Bridge Back To Life Center, Inc.
Bridge Back To Life Center, Inc. is an health care organization with primary practice located at 4271 Hempstead Tpke , Bethpage NY 11714-5708. The organization recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Nursing Service Providers / Addiction (Substance Use Disorder), Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder. Behavioral Health & Social Service Providers / Clinical is the primary health care specialty.
Bridge Back To Life Center, Inc. can be contacted via phone (516) 520-6600, or through Butchen, Gary via phone (516) 520-6600.
Contact Information
Primary practice address
4271 Hempstead Tpke
Bethpage NY 11714-5708
Phone: (516) 520-6600
Fax: (212) 520-6750
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 160310678 | New York |
| Nursing Service Providers / Addiction (Substance Use Disorder) | 163WA0400X | 160310678 | New York |
| Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder | 261QR0405X |
Profile Details
| NPI number | 1265859078 |
|---|---|
| LBN Legal business name | Bridge Back To Life Center, Inc. |
| DBA Doing business as | |
| Authorized official | Butchen, Gary LCSW-R, SAP |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Mar 19th, 2014 |
| Last updated | Nov 7th, 2018 - about 7 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1265859078 | NPPES |
| New York | MEDICAID | 01439087 |
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