Organization
BRIDGEWELLNEXUS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYNISHA ANASTASIA BROOKS (CEO)
(323) 974-5309
Entity
Organization
Contact information
Practice address
400 CORPORATE POINTE STE 300, CULVER CITY, CA 90230-7620
(323) 974-5309
Mailing address
400 CORPORATE POINTE STE 300, CULVER CITY, CA 90230-7620
(323) 974-5309
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
104100000X
Social Worker
—
—
164X00000X
Licensed Vocational Nurse
—
—
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
—
—
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
332U00000X
Home Delivered Meals
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
01/29/2025
Last updated
01/29/2025
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