Organization
BRIDGES HABILITATION SERVICES, INC.
Active
Other names
Bridges
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID M CANEN (CEO)
(307) 789-0664
Entity
Organization
Contact information
Practice address
1425 HIGHWAY 150 S STE 2, EVANSTON, WY 82930-5377
(307) 789-0664
(307) 222-0614
Mailing address
PO BOX 1642, EVANSTON, WY 82931-1642
(307) 789-0664
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115726400
—
WY
Enumeration date
08/03/2017
Last updated
08/03/2017
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