Organization
ILLINOIS MEDICAID-SUBSTANCE ABUSE GALESBURG
Active
Parent organization
BRIDGEWAY, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
BRIDGEWAY, INC.
Authorized official
MR. BILL ARTHUR NELSON LCPC (CEO)
(309) 344-4200
Entity
Organization
Contact information
Practice address
2323 WINDISH DR, GALESBURG, IL 61401-9780
(309) 344-4200
(309) 344-4281
Mailing address
2323 WINDISH DR, GALESBURG, IL 61401-9780
(309) 344-4200
(309) 344-4281
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
A-0118-0005-A
IL
261QM2800X
Methadone Clinic
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
IL
Other
Enumeration date
09/04/2015
Last updated
08/19/2019
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