# BRIDGEWAY CLINICS LLC

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

## Provider details

- **NPI number:** 1609510809
- **Authorized official:** SHEILA HALE (DIRECTOR OF FINANCE)
- **Authorized official phone:** (816) 786-4253

## Contact information

- **Practice address:** 4429 S RIVER BLVD, INDEPENDENCE, MO 64055-4659
- **Practice address phone:** (816) 786-4253
- **Mailing address:** 4429 S RIVER BLVD, INDEPENDENCE, MO 64055-4659
- **Mailing address phone:** (816) 786-4253

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084B0040X | Behavioral Neurology & Neuropsychiatry Physician | — | NULL | — |
| 2084B0040X | Behavioral Neurology & Neuropsychiatry Physician | — | — | — |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/24/2022
- **Last updated:** 11/30/2022