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Organization

BUILDING HEALTHY BRIDGES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ZANDRA TYLER (PRESIDENT)
(888) 311-4355
Entity
Organization

Contact information

Practice address
10834 S WABASH AVE, CHICAGO, IL 60628-3531
(888) 311-4355
Mailing address
PO BOX 439408, CHICAGO, IL 60643-9408

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YA0400X
Addiction (Substance Use Disorder) Counselor
103T00000X
Psychologist
103TP2701X
Group Psychotherapy Psychologist
104100000X
Social Worker
251E00000X
Home Health Agency
Primary
251J00000X
Nursing Care Agency
253Z00000X
In Home Supportive Care Agency
372500000X
Chore Provider
372600000X
Adult Companion
374U00000X
Home Health Aide
376J00000X
Homemaker
376K00000X
Nurse's Aide

Other

Enumeration date
07/09/2009
Last updated
04/07/2011
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