Organization
BRIDGE RESIDENTIAL SUPPORT SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IDRIS NANEY DSP (CEO)
(207) 409-4774
Entity
Organization
Contact information
Practice address
10902 JAYNES PLZ, OMAHA, NE 68164-4411
(207) 409-4774
Mailing address
10902 JAYNES PLZ, OMAHA, NE 68164-4411
(207) 409-4774
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
07/23/2022
Last updated
07/23/2022
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