BRIDGEWATER SUPPORT SERVICES, LLC (NPI# 1225427917) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225427917 |
| Entity Type | Organization |
| Organization Name | BRIDGEWATER SUPPORT SERVICES, LLC |
| Practice Address |
8139 Ernst Rd Manchester MI 48158-9565 |
| Practice Telephone | 7342762765 |
| Mailing Telephone | 7342762765 |
| Enumeration Date | 2015-01-18 |
| Last Update Date | 2015-01-18 |
| Authorized Official Name | MRS. AMBER DAWN BURKHARDT-SIDEBOTTOM (CLINICAL SOCIAL WORKER) |
| Authorized Official Telephone | 7342762765 |
| Authorized Official Credential | LMSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
6801087977 | MI | Ambulatory Health Care Facilities |
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
6801087977 | MI | Ambulatory Health Care Facilities |
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
6801087977 | MI | Ambulatory Health Care Facilities |
| Street Address |
8139 ERNST RD |
| City | MANCHESTER |
| State | MI |
| Zip Code | 48158-9565 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003332651 | Jessica L Walz | Specialist/Technologist | 9235 Grossman Rd, Manchester, MI 48158 | 2017-08-16 |
| 1548464951 | Great Lakes Bay Health Centers | Clinic/Center | 4800 Esch Road, Manchester Migrant Camp, Manchester, MI 48158 | 2007-06-12 |
| 1952427841 | Bruce Alan Bates | Dentist | 500 Galloway Dr, Manchester, MI 48158 | 2007-03-22 |
| 1114083581 | Dana Ray Andrews | Chiropractor | 102 S. Clinton St., Suite 1, Manchester, MI 48158 | 2006-12-29 |
| 1538485602 | Aaron Larock | Dentist | 126 E. Main St, Apartment 2, Manchester, MI 48158 | 2010-04-14 |
| 1427114693 | Andrews Family Chiropractic Pllc | Chiropractor | 102 S. Clinton St., Suite 1, Manchester, MI 48158 | 2006-12-29 |
| 1396930533 | Margaret Anne Steeb | Dietitian, Registered | 216 N. Washington St, Unit # 3, Manchester, MI 48158-0504 | 2007-09-11 |
| 1720248016 | Gayle Anne Antonelli | Physician Assistant | 122 W Main St, Manchester, MI 48158-1002 | 2008-06-11 |
| 1679776264 | Evelyn Eccles, Md | Family Medicine | 122 W Main St, Box 570, Manchester, MI 48158-1002 | 2007-06-09 |
| 1366533689 | Evelyn Eccles | Family Medicine | 122 W Main St, Box 570, Manchester, MI 48158-1002 | 2006-09-28 |
| Find all providers in zip 48158 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
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|---|---|---|---|---|
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| 1609848811 | The Mental Health Center of Greater Manchester | Clinic/Center | 401 Cypress Street, Manchester, NH 03103 | 2006-02-02 |
| 1982970885 | Katherine I. Thonis, LLC | Clinic/Center | 250 Commercial St, Suite # 1012 B, Manchester, NH 03101-1142 | 2012-03-26 |
| 1346436490 | Advanced Practice Psychiatric Nurses Pllc | Clinic/Center | 61 North St, Manchester, NH 03104-3029 | 2007-09-22 |
| 1093931479 | James J. Foster & Associates, Ltd | Clinic/Center | 540 Chestnut St, Suite 102, Manchester, NH 03101-1447 | 2007-04-17 |
| 1982667929 | Delaware County Memorial Hospital | Clinic/Center | 709 W Main St, Manchester, IA 52057-1526 | 2006-04-10 |
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| 1619595832 | Peace of Mind, LLC | Clinic/Center | 41750 Foster Dr Unit 204, Novi, MI 48375-1976 | 2020-07-14 |
| Find all providers with the same taxonomy | ||||
| City | MANCHESTER |
| Zip Code | 48158 |
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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.