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
1089 HAWKINSON AVE, GALESBURG, IL 61401-6900
(309) 343-2639
(309) 341-4770
Mailing address
1089 HAWKINSON AVE, GALESBURG, IL 61401-6900
(309) 343-2639
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
IL
310500000X
Mental Illness Intermediate Care Facility
-031
IL
Other
Enumeration date
04/12/2007
Last updated
07/21/2022
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