Provider Demographics
NPI:1164382032
Name:BRIDGE OF SUPPORT SERVICES
Entity type:Organization
Organization Name:BRIDGE OF SUPPORT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:RITA
Authorized Official - Middle Name:L
Authorized Official - Last Name:ANDRUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-957-4503
Mailing Address - Street 1:3465 S ARLINGTON RD STE E
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44312-5272
Mailing Address - Country:US
Mailing Address - Phone:330-957-4503
Mailing Address - Fax:
Practice Address - Street 1:2705 MAYFAIR CIR
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44312-5402
Practice Address - Country:US
Practice Address - Phone:330-957-4503
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-13
Last Update Date:2025-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care