Organization
BRIDGEWAY RECOVERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SIRAH ALI LICSW (CEO)
(612) 293-0055
Entity
Organization
Contact information
Practice address
501 GATEWAY BLVD APT 115, BURNSVILLE, MN 55337-2517
(612) 293-0055
Mailing address
501 GATEWAY BLVD APT 115, BURNSVILLE, MN 55337-2517
(612) 293-0055
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
01/18/2024
Last updated
06/06/2024
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