Provider Demographics
NPI:1710790399
Name:BRIDGES PROFESSIOANL TREATMENT SERVICES
Entity type:Organization
Organization Name:BRIDGES PROFESSIOANL TREATMENT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:KNUTSON
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:916-203-7848
Mailing Address - Street 1:3600 POWER INN RD STE C
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95826-3826
Mailing Address - Country:US
Mailing Address - Phone:916-450-0700
Mailing Address - Fax:
Practice Address - Street 1:2401 YREKA AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95822-4465
Practice Address - Country:US
Practice Address - Phone:916-450-0700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BRIDGES PROFESSIOANL TREATMENT SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility