THE BRIDGE TO LIFE RESOURCES INC (NPI# 1114357647) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114357647 |
| Entity Type | Organization |
| Organization Name | THE BRIDGE TO LIFE RESOURCES INC |
| Practice Address |
104 Market St Brockton MA 02301-6736 |
| Practice Telephone | 6174626733 |
| Practice Fax Number | 7819638992 |
| Mailing Telephone | 6174626733 |
| Mailing Fax Number | 7819638992 |
| Enumeration Date | 2013-11-19 |
| Last Update Date | 2013-11-19 |
| Authorized Official Name | MICHELE PADYMOISE (DIRECTOR) |
| Authorized Official Telephone | 6174626733 |
| Authorized Official Credential | REGISTERED NURSE |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3747A0650X |
Technician Specialization: Attendant Care Provider |
Nursing Service Related Providers | ||
| N | 385H00000X | Respite Care | Respite Care Facility | ||
| Y | 373H00000X | Day Training/Habilitation Specialist | Nursing Service Related Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 1041 | 05 |
| Street Address |
104 MARKET ST |
| City | BROCKTON |
| State | MA |
| Zip Code | 02301-6736 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194155747 | Carl Moise | Case Manager/Care Coordinator | 104 Market St, Brockton, MA 02301-6736 | 2013-11-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942807110 | Jenny Vulpis | Recreation Therapist | 940 Belmont St (br 135), Brockton, MA 02301 | 2020-10-01 |
| 1205444924 | Caroline Storey | Counselor | Men's Addiction Treatment Center, 10 Meadowbrook Road, Brockton, MA 02301 | 2020-07-20 |
| 1013546852 | Nuria Dos Santos Veiga | Occupational Therapist | 73 Denton St, Brockton, MA 02301 | 2020-04-03 |
| 1679113930 | Laura Ann Brondyk II | Counselor | 10 Christys Dr, Brockton, MA 02301 | 2020-01-14 |
| 1437796521 | Andrea Lopes | Developmental Therapist | 7 Goddard Road, Brockton, MA 02301 | 2019-12-08 |
| 1518420124 | Diligencehealthcare | Psychiatry & Neurology | 30-40 Westpark Street, Brockton, MA 02301 | 2019-04-10 |
| 1124530373 | Rachel Theys | Behavioral Analyst | 130 Liberty St Ste 13a, Brockton, MA 02301 | 2017-10-27 |
| 1689193369 | Anderson D Delgado | Behavior Technician | 11 Packard Way, Brockton, MA 02301 | 2017-09-14 |
| 1811415326 | Francesca Lavecchia | Clinical Neuropsychologist | Brockto Area Multi Service, Inc. 10 Christy Dr., Brockton, MA 02301 | 2017-09-05 |
| 1831615343 | Donna Marie Dugan | Counselor | South Bay Community Services, 340 Main Street - Suite 818, Worcester, MA 02301 | 2017-08-16 |
| Find all providers in zip 02301 | ||||
| Taxonomy Code | 373H00000X |
| Grouping | Nursing Service Related Providers |
| Classification | Day Training/Habilitation Specialist |
| Individuals experienced or trained in working with developmentally disabled individuals who need assistance in acquiring and maintaining life skills that enable them to cope more effectively with the demands of independent living. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518467562 | Amanda Leigh Wetherell | Day Training/Habilitation Specialist | 103 Commercial St, Brockton, MA 02302-3101 | 2018-02-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881972750 | Shirley Anne Blanchard | Day Training/Habilitation Specialist | 15 Pine Trl, West Brookfield, MA 01585-2804 | 2011-07-26 |
| 1508923780 | Rogerson Communities | Day Training/Habilitation Specialist | 23 Florence St, Boston, MA 02131-3638 | 2007-01-03 |
| 1902963184 | Rogerson Communities | Day Training/Habilitation Specialist | 93 Winchester St, Brookline, MA 02446-2755 | 2007-01-03 |
| 1376600569 | Rogerson Communities | Day Training/Habilitation Specialist | 2053r Columbus Avenue, Roxbury, MA 02119 | 2007-01-03 |
| 1376155242 | April Renee Figueiredo | Day Training/Habilitation Specialist | 34 River St, Braintree, MA 02184-3237 | 2020-08-20 |
| 1770046922 | Mallery Lee Guastini | Day Training/Habilitation Specialist | 80 Erdman Way, Leominster, MA 01453-1840 | 2019-04-12 |
| 1538524780 | Amanda Gallant | Day Training/Habilitation Specialist | 31 Lake St, Gardner, MA 01440-3879 | 2015-12-15 |
| 1518091875 | Preparatory Rehabilitation for Individual Development & Employment, In | Day Training/Habilitation Specialist | 3 Maple St, Taunton, MA 02780-3012 | 2007-03-16 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.