| Organization Name: | BRIDGEWAY, INC |
| NPI Number: | 1154545879 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JIM STARNES (CEO) |
| Mailing Address: | 1089 Hawkinson Ave Galesburg |
| State: | IL US |
| Postal Code: | 614016900 |
| Phone Number: | 3093432639 |
| Fax Number: | |
| NPI Enumeration Date: | 04/12/2007 |
| NPI Last Update Date: | 04/20/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 310500000X |
| License Number: | =========-031 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Nursing & Custodial Care Facilities |
| Taxonomy Classification: | Intermediate Care Facility, Mental Illness |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A nursing facility that provides an intermediate level of nursing care to individuals whose functional abilities are significantly compromise by mental illness. |