Provider Demographics
NPI:1740657527
Name:THE BRIDGE OF CENTRAL MASSACHUSETTS, INC.
Entity type:Organization
Organization Name:THE BRIDGE OF CENTRAL MASSACHUSETTS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EVP - CFO AND COO
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:BENVENUTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-318-7405
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 1:288 GROVE ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-3934
Practice Address - Country:US
Practice Address - Phone:508-755-0333
Practice Address - Fax:508-755-2191
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE BRIDGE OF CENTRAL MASSACHUSETTS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-08-27
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental DisabilitiesGroup - Multi-Specialty