Provider Demographics
NPI:1811328743
Name:NEWBRIDGE BEHAVIORAL HEALTH LLC
Entity type:Organization
Organization Name:NEWBRIDGE BEHAVIORAL HEALTH LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-644-1500
Mailing Address - Street 1:1801 LEE RD
Mailing Address - Street 2:SUITE 115
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-2162
Mailing Address - Country:US
Mailing Address - Phone:407-644-1500
Mailing Address - Fax:
Practice Address - Street 1:1801 LEE RD
Practice Address - Street 2:SUITE 115
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-2162
Practice Address - Country:US
Practice Address - Phone:407-644-1500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-03
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0948AD589701261QM0850X
FL0948AD639403261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health