Organization
BRIDGEWELL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LYNN-MARIE LEWIS (BILLING MANAGER)
(339) 883-2166
Entity
Organization
Contact information
Practice address
162 BOSTON ST, LYNN, MA 01904-3133
(339) 883-1700
Mailing address
471 BROADWAY, LYNNFIELD, MA 01940
(339) 883-2166
(339) 883-2187
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1307673
—
MA
05
—
1308572
—
MA
05
—
1308599
—
MA
05
—
1312022
—
MA
05
—
1312049
—
MA
Enumeration date
01/19/2007
Last updated
02/07/2023
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