# BRIDGEWAY BEHAVIORAL HEALTH SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184748535
- **Authorized official:** MR. MOHSAN JAN (DIRECTOR OF BILLING & REIMBURSEMENT)
- **Authorized official phone:** (908) 355-7886

## Contact information

- **Practice address:** 615 N BROAD ST, ELIZABETH, NJ 07208-3409
- **Practice address phone:** (908) 355-7886
- **Practice address fax:** (908) 355-6668
- **Mailing address:** 373 CLERMONT TER, UNION, NJ 07083-8073
- **Mailing address phone:** (908) 355-7886
- **Mailing address fax:** (908) 248-9376

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | 204010310 | NJ | Yes |
| 251S00000X | Community/Behavioral Health Agency | 204011310 | NJ | — |

## Other

- **Enumeration date:** 03/19/2007
- **Last updated:** 03/04/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 8819009 | — | NJ |