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Organization
LIFEBRIDGE COMMUNITY SERVICES, INC.
Active
Organization
LIFEBRIDGE COMMUNITY SERVICES, INC.
Active
Other names
FSW, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
FRANK FARIAS (CHIEF FINANCIAL & HR OFFICER)
(203) 368-4291
Entity
Organization
Contact information
Practice address
475 CLINTON AVE, BRIDGEPORT, CT 06605-1700
(203) 368-4291
(203) 368-9167
Mailing address
475 CLINTON AVE, BRIDGEPORT, CT 06605-1700
(203) 368-4291
(203) 368-9167
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
CT
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004069985
—
CT
Enumeration date
07/13/2005
Last updated
11/18/2020
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