| Bridges | |
|
400 S Kendrick Ave Suite 201d Gillette WY 82716-3848 | |
| (307) 685-7105 | |
| (307) 222-0614 |
| Full Name | Bridges |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 400 S Kendrick Ave, Gillette, Wyoming |
| Authorized Official Name and Position | David M Canen (CEO) |
| Authorized Official Contact | 3077890664 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bridges Po Box 1642 Evanston WY 82931-1642 Ph: (307) 789-0664 | Bridges 400 S Kendrick Ave Suite 201d Gillette WY 82716-3848 Ph: (307) 685-7105 |
| NPI Number | 1710392220 |
|---|---|
| Provider Enumeration Date | 06/23/2014 |
| Last Update Date | 06/23/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710392220 | NPI | - | NPPES |
| 1245305804 | Medicaid | WY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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