Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Bridge Residential Home LLC

Organization Cognitive & Behavioral Psychologist · NPI 1114781945

Bridge Residential Home LLC is a Cognitive & Behavioral Psychologist in Laveen, Arizona. Registered with an NPI since 2024.

In the registry since
2024
Specialties on file
5
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

7343 W Maldonado Rd
Laveen, AZ 85339-7001
Phone: (602) 354-9252
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric Residential Treatment Facility (primary) Taxonomy 323P00000X
Cognitive & Behavioral Psychologist Taxonomy 103TB0200X
Addiction Medicine (Psychiatry & Neurology) Physician Taxonomy 2084A0401X
Substance Abuse Rehabilitation Facility Taxonomy 324500000X
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X

Record details

NPI number1114781945
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Wildine Burgess — Exec Admin · (602) 354-9252
NPI enumeratedFebruary 12, 2024
Last updated in NPPESFebruary 12, 2024
Certification dateFebruary 12, 2024
Mailing addressPo Box 51382, Phoenix, AZ 85076-1382

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