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Organization
BRIDGEWAY, INC
Active
Organization
BRIDGEWAY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM NELSON (CEO)
(309) 344-2323
Entity
Organization
Contact information
Practice address
639 HAWTHORNE CT, GALESBURG, IL 61401-1200
(309) 344-2323
Mailing address
2323 WINDISH DR, GALESBURG, IL 61401-9780
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
310500000X
Mental Illness Intermediate Care Facility
—
—
Other
Enumeration date
02/14/2008
Last updated
04/12/2018
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