Organization
ILLINOIS MEDICAID-SUBSTANCE ABUSE GALESBURG
Active
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
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up