Bridge Of Love Ii Llc | |
331 Margate Rd Upper Darby PA 19082-4613 | |
(484) 424-6629 | |
Not Available |
Full Name | Bridge Of Love Ii Llc |
---|---|
Speciality | Social Worker |
Location | 331 Margate Rd, Upper Darby, Pennsylvania |
Authorized Official Name and Position | Bridgette Montgomery (OWNER/THERAPIST) |
Authorized Official Contact | 2672068762 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Bridge Of Love Ii Llc 18 Campus Blvd Ste 100 Newtown Square PA 19073-3240 Ph: (484) 423-3426 | Bridge Of Love Ii Llc 331 Margate Rd Upper Darby PA 19082-4613 Ph: (484) 424-6629 |
NPI Number | 1427566645 |
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Provider Enumeration Date | 01/22/2018 |
Last Update Date | 02/14/2024 |
Certification Date | 02/14/2024 |
Medicare PECOS PAC ID | 3971864703 |
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Medicare Enrollment ID | O20180219001577 |
Identifier | Type | State | Issuer |
---|---|---|---|
1427566645 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Provider Name | Bridgette Nciole Montgomery |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1417343021 PECOS PAC ID: 4880955616 Enrollment ID: I20180219001703 |
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