Provider Demographics
NPI:1235974064
Name:BRIDGE TO CONNECTION
Entity type:Organization
Organization Name:BRIDGE TO CONNECTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:MADALINA
Authorized Official - Middle Name:ELENA
Authorized Official - Last Name:LEANGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-600-5852
Mailing Address - Street 1:3119 N SPRINGFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-6516
Mailing Address - Country:US
Mailing Address - Phone:773-600-5852
Mailing Address - Fax:
Practice Address - Street 1:3119 N SPRINGFIELD AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-6516
Practice Address - Country:US
Practice Address - Phone:773-600-5852
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-25
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty