Provider Demographics
NPI:1053746255
Name:THE BRIDGE OF CENTRAL MASSACHUSETTS, INC
Entity type:Organization
Organization Name:THE BRIDGE OF CENTRAL MASSACHUSETTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTR OF ADMINISTRATION AND FIANA
Authorized Official - Prefix:MR
Authorized Official - First Name:FRED
Authorized Official - Middle Name:
Authorized Official - Last Name:BATTERSBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-755-0333
Mailing Address - Street 1:4 MANN ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01602-3414
Mailing Address - Country:US
Mailing Address - Phone:508-755-0333
Mailing Address - Fax:508-755-2191
Practice Address - Street 1:4 MANN ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01602-3414
Practice Address - Country:US
Practice Address - Phone:508-755-0333
Practice Address - Fax:508-755-2191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-06
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110087658AMedicare PIN