| Bridge Back To Life Inc | |
|
4271 Hempstead Tpke Bethpage NY 11714-5708 | |
| (516) 520-6600 | |
| Not Available |
| Full Name | Bridge Back To Life Inc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 4271 Hempstead Tpke, Bethpage, New York |
| Authorized Official Name and Position | Gary Butchen (EXECUTIVE DIREC TOR) |
| Authorized Official Contact | 2126794960 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bridge Back To Life Inc 4271 Hempstead Tpke Bethpage NY 11714-5708 Ph: (516) 520-6600 | Bridge Back To Life Inc 4271 Hempstead Tpke Bethpage NY 11714-5708 Ph: (516) 520-6600 |
| NPI Number | 1194132175 |
|---|---|
| Provider Enumeration Date | 07/22/2014 |
| Last Update Date | 07/22/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194132175 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 003103 (New York) | Primary |
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