| Organization Name: | BRIDGE TO CHANGE LLC |
| NPI Number: | 1164782488 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KAREN LOONEY-MASTERSON (EXECUTIVE DIRECTOR/OWNER/COUNSELOR) |
| Mailing Address: | 470 Schooley's Mountain Road Hastings Square Suite 10 Hackettstown |
| State: | NJ US |
| Postal Code: | 07840 |
| Phone Number: | 9082464011 |
| Fax Number: | |
| NPI Enumeration Date: | 05/21/2012 |
| NPI Last Update Date: | 05/21/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |