Provider Demographics
NPI:1609929959
Name:BRIDGES OF MISSOURI INC.
Entity type:Organization
Organization Name:BRIDGES OF MISSOURI INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:IMHOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-781-7900
Mailing Address - Street 1:3114 SUTTON BLVD
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63143-3910
Mailing Address - Country:US
Mailing Address - Phone:314-781-7900
Mailing Address - Fax:314-781-7914
Practice Address - Street 1:3114 SUTTON BLVD
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MO
Practice Address - Zip Code:63143-3910
Practice Address - Country:US
Practice Address - Phone:314-781-7900
Practice Address - Fax:314-781-7914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO=========01OtherBOMI BSHCN ID