| Bridgeway Health Services, Llc | |
|
1032 S. Bridgeway Pl, Ste 110 Eagle ID 83616 | |
| (208) 475-0800 | |
| (208) 639-0901 |
| Full Name | Bridgeway Health Services, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1032 S. Bridgeway Pl,, Eagle, Idaho |
| Authorized Official Name and Position | Grant Belnap (OWNER) |
| Authorized Official Contact | 2082460123 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bridgeway Health Services, Llc 1032 S. Bridgeway Pl, Ste 110 Eagle ID 83616 Ph: (208) 475-0800 | Bridgeway Health Services, Llc 1032 S. Bridgeway Pl, Ste 110 Eagle ID 83616 Ph: (208) 475-0800 |
| NPI Number | 1265703953 |
|---|---|
| Provider Enumeration Date | 01/26/2012 |
| Last Update Date | 01/26/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265703953 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | M7357 (Idaho) | Primary |
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