Organization
BRIDGEWAY REHABILITATION SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN MALLOY MA, LPC, ACS (DIRECTOR)
(732) 755-7078
Entity
Organization
Contact information
Practice address
130 POWERVILLE RD, BOONTON, NJ 07005-8705
(732) 755-7078
Mailing address
282 E MAIN ST, SOMERVILLE, NJ 08876-3006
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/21/2024
Last updated
10/21/2024
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