Organization
BRIDGES OF HOPE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARL WATERMAN (CEO)
(765) 643-0121
Entity
Organization
Contact information
Practice address
2200 MADISON SQ, ANDERSON, IN 46011-9548
(765) 643-0121
(765) 643-0130
Mailing address
2200 MADISON SQ, ANDERSON, IN 46011-9548
(765) 643-0121
(765) 643-0130
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300006987
GROUP MEDICAID
IN
01
—
IN3606
GROUP MEDICARE
IN
Enumeration date
10/17/2016
Last updated
05/03/2023
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