Provider Demographics
NPI:1861294597
Name:BRIDGEWAY BEHAVIORAL HEALTH SERVICES
Entity type:Organization
Organization Name:BRIDGEWAY BEHAVIORAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BILLING & REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:MOHSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:JAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-384-3706
Mailing Address - Street 1:373 CLERMONT TER
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-8073
Mailing Address - Country:US
Mailing Address - Phone:908-384-3706
Mailing Address - Fax:
Practice Address - Street 1:373 CLERMONT TER
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-8073
Practice Address - Country:US
Practice Address - Phone:908-355-7886
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health