Organization
BRIDGES HABILITATION SERVICES, INC.
Active
Other names
Bridges
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID M CANEN (CEO)
(307) 789-0664
Entity
Organization
Contact information
Practice address
400 S KENDRICK AVE, SUITE 201D, GILLETTE, WY 82716-3848
(307) 685-7105
(307) 222-0614
Mailing address
PO BOX 1642, EVANSTON, WY 82931-1642
(307) 789-0664
(307) 789-1902
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245305804
—
WY
Enumeration date
06/23/2014
Last updated
06/23/2014
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