| NPI | 1902101546 |
|---|---|
| Former Legal Business Name | BRIDGEWAY BEHAVIORAL HEALTH |
| Entity Type | Organization |
| Authorized Contact | MARK CONOVER Chief Revenue Officer 573-603-1460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: MO 1290-7765) |
| Enumeration Date | 2011-01-12 |
| Last Update Date | 2022-07-29 |