OrganizationActive
Bridge Residential Home LLC
NPI 1114781945 · Psychiatric Residential Treatment Facility · Laveen, AZ
Provider details
- NPI number
- 1114781945
- Entity type
- Organization
- Primary specialty
- Psychiatric Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Wildine Burgess, Exec Admin(602) 354-9252
Specialties & taxonomies
Residential Treatment Facilities
Allopathic & Osteopathic Physicians
- Cognitive & Behavioral Psychologist103TB0200X
Behavioral Health & Social Service Providers
- Substance Abuse Rehabilitation Facility324500000X
Residential Treatment Facilities
Physician Assistants & Advanced Practice Nursing Providers
Practice location
7343 W Maldonado Rd
Laveen, AZ 85339-7001
Phone: (602) 354-9252
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 51382
Phoenix, AZ 85076-1382
Registry dates
- Enumerated
- 2024-02-12
- Last updated
- 2024-02-12
- Certified
- 2024-02-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.