Organization
BRIDGEWAY CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BONNIE R BARLOW (CHIEF EXECUTIVE OFFICER)
(850) 833-3975
Entity
Organization
Contact information
Practice address
137 HOSPITAL DR NE, FORT WALTON BEACH, FL 32548-5063
(850) 833-7547
(850) 833-7528
Mailing address
137 HOSPITAL DR NE, FORT WALTON BEACH, FL 32548-5063
(850) 833-7547
(850) 833-7528
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
0146AD8085-01
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
060398802
—
FL
Enumeration date
09/03/2008
Last updated
06/02/2021
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