Organization
BRIDGEWAY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM NELSON (CEO)
(309) 344-2323
Entity
Organization
Contact information
Practice address
1220 W DIVISION ST, KEWANEE, IL 61443-3390
(309) 853-4325
(309) 853-4385
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
—
IL
101YM0800X
Mental Health Counselor
—
IL
171M00000X
Case Manager/Care Coordinator
—
IL
2084P0800X
Psychiatry Physician
—
IL
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
04/17/2007
Last updated
07/21/2022
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