BRIDGE BACK TO LIFE (NPI# 1962862987) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962862987 |
| Entity Type | Organization |
| Organization Name | BRIDGE BACK TO LIFE |
| Practice Address |
500 8th Ave Rm 906 New York NY 10018-4190 |
| Practice Telephone | 2126794960 |
| Practice Fax Number | 2123995444 |
| Enumeration Date | 2016-03-03 |
| Last Update Date | 2016-03-03 |
| Authorized Official Name | MR. ANTHONY DEMMA (DIRECTOR) |
| Authorized Official Telephone | 2126794960 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3245S0500X |
Substance Abuse Rehabilitation Facility Specialization: Substance Abuse Treatment, Children |
Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083942411 | Bridge Back To Life | Clinic/Center | 500 8th Ave Rm 906, New York, NY 10018-4190 | 2009-11-23 |
| 1700114139 | Bridge Back To Life | Clinic/Center | 500 8th Ave Rm 906, New York, NY 10018-4190 | 2009-11-23 |
| Street Address |
500 8TH AVE RM 906 |
| City | NEW YORK |
| State | NY |
| Zip Code | 10018-4190 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215185707 | Hilda Dozier | Counselor | 500 8th Ave Rm 906, New York, NY 10018-4190 | 2008-09-09 |
| 1144637398 | Qiana Ware | Counselor | 500 8th Ave Rm 906, New York, NY 10018-4190 | 2014-07-21 |
| 1366877961 | Koichi Togawa | Counselor | 500 8th Ave Rm 906, New York, NY 10018-4190 | 2013-09-13 |
| 1942646096 | Paul Fishkin | Counselor | 500 8th Ave Rm 906, New York, NY 10018-4190 | 2013-05-16 |
| 1245676436 | Gary Alleyne | Counselor | 500 8th Ave Rm 906, New York, NY 10018-4190 | 2013-05-15 |
| 1407292790 | Anthony Scolavino | Counselor | 500 8th Ave Rm 906, New York, NY 10018-4190 | 2013-05-14 |
| 1487997904 | Christina M Penna | Counselor | 500 8th Ave Rm 906, New York, NY 10018-4190 | 2013-04-03 |
| 1780927202 | Johanna M Caruso | Counselor | 500 8th Ave Rm 906, New York, NY 10018-4190 | 2013-04-03 |
| 1790023927 | Gabrielle Jakob | Counselor | 500 8th Ave Rm 906, New York, NY 10018-4190 | 2013-01-23 |
| 1235497066 | Merily Mclaughlin | Counselor | 500 8th Ave Rm 906, New York, NY 10018-4190 | 2012-04-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205451325 | Nishi Sanjay Patel | Physical Therapist | 12 West 37th Street, Suite 1202, New York, NY 10018 | 2020-06-15 |
| 1962023168 | Brand Therapy Psychological Services PC | Psychologist | 50 West 39th St, Suite 305, New York, NY 10018 | 2020-04-29 |
| 1215587985 | Nicole Kosanke | Psychologist | 519 8th Avenue, 9th Floor, New York, NY 10018 | 2019-09-16 |
| 1487216073 | Roselaure Luca | Nurse Practitioner | 5 Bryant Park, 5th Floor, New York, NY 10018 | 2019-07-03 |
| 1609439942 | Kamiyama Physical Therapy Pllc | Physical Therapist | 1410 Broadway Concourse Level, New York, NY 10018 | 2019-04-22 |
| 1609339126 | Bryan I. Proano | Social Worker | 550 10th Ave., New York, NY 10018 | 2019-04-11 |
| 1053876318 | Nitzia Mariana Dacosta | Registered Nurse | 505 8th Ave Suite 200, New York, NY 10018 | 2019-01-31 |
| 1871060640 | Jose Jean Paul Miliano | Case Manager/Care Coordinator | 535 Eighth Avenue. 2nd Floor, New York, NY 10018 | 2018-10-30 |
| 1902372220 | Stephanie Lai | Social Worker | 550 Tenth Avenue, New York, NY 10018 | 2018-10-15 |
| 1528554912 | Positive Health Project, Inc. | Counselor | 301 W 37th St Fl 3, New York, NY 10018 | 2018-07-09 |
| Find all providers in zip 10018 | ||||
| Taxonomy Code | 3245S0500X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| Specialization | Substance Abuse Treatment, Children |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003348939 | Start Where You Stand, Inc. | Substance Abuse Rehabilitation Facility | 14502 123rd Ave, Private, South Ozone Park, NY 11436-1618 | 2017-03-30 |
| 1376932558 | Hope House, Inc. | Substance Abuse Rehabilitation Facility | 577 Livingston Ave., Albany, NY 12206 | 2015-01-12 |
| 1699197053 | Renaissance Addiction Services, Inc. | Substance Abuse Rehabilitation Facility | 920 Harlem Rd, West Seneca, NY 14224-1008 | 2014-01-20 |
| 1861664617 | Lasalle School | Substance Abuse Rehabilitation Facility | 391 Western Ave, Albany, NY 12203-1491 | 2008-04-01 |
| 1245352525 | Daytop Village, Inc. | Substance Abuse Rehabilitation Facility | 220 Fox Hollow Road, Rhinebeck, NY 12572 | 2007-04-06 |
| 1598802514 | Berkshire Farm Center and Services for Youth | Substance Abuse Rehabilitation Facility | 13640 Rte 22, Canaan, NY 12029 | 2007-01-31 |
| 1255482535 | Prcd, Inc. | Substance Abuse Rehabilitation Facility | 2654 Ridgeway Ave, Rochester, NY 14626-4209 | 2007-01-15 |
| 1891896767 | Can/am Youth Services, Inc. | Substance Abuse Rehabilitation Facility | 100 County Route 43, Massena, NY 13662-4104 | 2006-09-25 |
| 1326690611 | North Country Freedom Homes, Inc. | Substance Abuse Rehabilitation Facility | 25 Dies St, Canton, NY 13617-1306 | 2019-07-16 |
| 1508317561 | Ymca of Greater Ny | Substance Abuse Rehabilitation Facility | 3911 Richmond Ave, Staten Island, NY 10312-5110 | 2016-10-14 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on BRIDGE BACK TO LIFE.
| 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.