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
7 POLLOCK DR, MACOMB, IL 61455-1216
(309) 833-5737
Mailing address
2323 WINDISH DR, GALESBURG, IL 61401-9780
(309) 344-4208
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
315P00000X
Intellectual Disabilities Intermediate Care Facility
025
IL
Other
Enumeration date
04/11/2007
Last updated
07/21/2022
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