Organization
JIMAC LLC
Active
Other names
THE BRIDGE HEALTHCARE
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN JOHN MARCUS (PROGRAM DIRECTOR)
(602) 561-4951
Entity
Organization
Contact information
Practice address
10828 W ELM ST, PHOENIX, AZ 85037-1091
(602) 561-4951
Mailing address
10828 W ELM ST, PHOENIX, AZ 85037-1091
(602) 561-4951
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
103TC1900X
Counseling Psychologist
—
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
—
—
Other
Enumeration date
06/08/2022
Last updated
06/08/2022
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