Organization
BRIDGE BACK TO LIFE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETSY J HAMILTON LMSW (SOCIAL WORKER)
(718) 852-5552
Entity
Organization
Contact information
Practice address
175 REMSEN ST, 10TH FLOOR, BROOKLYN, NY 11201-4300
(718) 852-5552
Mailing address
175 REMSEN ST, 10TH FLOOR, BROOKLYN, NY 11201-4300
(718) 852-5552
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
079825-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
079825-1
LMSW
NY
Enumeration date
11/19/2009
Last updated
11/19/2009
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