| Bridge Partnership, Llc | |
|
2505 Black Rock Turnpike 2nd Floor Fairfield CT 06825 | |
| (203) 292-6949 | |
| Not Available |
| Full Name | Bridge Partnership, Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 2505 Black Rock Turnpike, Fairfield, Connecticut |
| Authorized Official Name and Position | Richard Patrick Douglas (OWNER/DIRECTOR) |
| Authorized Official Contact | 2032926949 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bridge Partnership, Llc 2505 Black Rock Turnpike 2nd Floor Fairfield CT 06825 Ph: (203) 292-6949 | Bridge Partnership, Llc 2505 Black Rock Turnpike 2nd Floor Fairfield CT 06825 Ph: (203) 292-6949 |
| NPI Number | 1710242870 |
|---|---|
| Provider Enumeration Date | 07/05/2012 |
| Last Update Date | 02/28/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710242870 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | 0-14-5069 (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | 1-11-8521 (Connecticut) | Secondary |
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