NPI | 1245557404 |
---|---|
Doing Business As | BRIDGEWAY PSYCHIATRIC CENTER PRACTICE MANAGEMENT |
Entity Type | Organization |
Authorized Contact | MARK CULLEN CEO 337-788-3330 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
Enumeration Date | 2010-04-28 |
Last Update Date | 2010-04-28 |