Organization
BRIDGING THE TYS TO JORDAN INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYSON EVERETT (EXECUTIVE DIRECTOR)
(773) 425-8159
Entity
Organization
Contact information
Practice address
5500 S INDIANA AVE BSMT, CHICAGO, IL 60637-1011
(773) 425-8159
(773) 488-9462
Mailing address
5500 S INDIANA AVE BSMT, CHICAGO, IL 60637-1011
(773) 425-8159
(773) 488-9462
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
A-3249-0001
IL
251S00000X
Community/Behavioral Health Agency
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
03/05/2008
Last updated
10/22/2025
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