Organization
NICASA - BRIDGE HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA SNELTEN (CHIEF OPERATING OFFICER)
(847) 546-6450
Entity
Organization
Contact information
Practice address
3016 GRAND AVE, WAUKEGAN, IL 60085-2321
(847) 662-4124
Mailing address
31979 N FISH LAKE RD, ROUND LAKE, IL 60073-9517
(847) 546-6450
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
08/13/2019
Last updated
04/06/2021
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