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A BRIDGE BACK, INC.
NPI 1093354037
Clinic/Center - Rehabilitation, Substance Use Disorder in Arlington Heights, IL

Active since December 21, 2019
1655 N ARLINGTON HEIGHTS RD # 305, ARLINGTON HEIGHTS, IL 60004(844) 427-6739 Get Directions Write a Review

NPPES record last updated: November 14, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Nov 14, 2024, Aug 4, 2020, Dec 21, 2019 (3 updates tracked since 2019).

Table of Contents

  1. NPI Profile Information
  2. Primary Taxonomy
  3. Authorized Official
  4. Frequently Asked Questions
  • Organization
  • Clinic/Center
  • Rehabilitation, Substance Use Disorder

About A BRIDGE BACK, INC.

This page provides the complete NPI Profile along with additional information for A Bridge Back, Inc., a provider established in Arlington Heights, Illinois operating as a Clinic/center, focusing in rehabilitation, substance use disorder . The healthcare provider is registered in the NPI registry with number 1093354037 assigned on December 2019. The practitioner's primary taxonomy code is 261QR0405X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The authorized official of this NPI record is Mr. Lucien Izraylov Ma, Cadc, Codp, Qmhp (President)

NPI
1093354037 Verify this NPI
Provider Name
A BRIDGE BACK, INC.
Entity Type
Organization
Location Address
1655 N ARLINGTON HEIGHTS RD # 305 ARLINGTON HEIGHTS, IL 60004
Location Phone
(844) 427-6739
Mailing Address
314 MCHENRY RD BUFFALO GROVE, IL 60089
Mailing Phone
(844) 427-6739
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
12-21-2019
Last Update Date
11-14-2024
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Rehabilitation, Substance Use Disorder

Taxonomy Code
261QR0405X
Type
Ambulatory Health Care Facilities

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. LUCIEN IZRAYLOV MA, CADC, CODP, QMHP

Authorized Official Title
PRESIDENT
Authorized Official Phone
(847) 877-2440

Reviews for A BRIDGE BACK, INC.

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Frequently Asked Questions

What is A BRIDGE BACK, INC.'s NPI number?

The NPI number assigned to this healthcare provider is 1093354037, enumerated as an "organization" on December 21, 2019.

Where is the provider located?

The provider is located at 1655 N ARLINGTON HEIGHTS RD # 305 ARLINGTON HEIGHTS, IL 60004 and the phone number is (844) 427-6739.

What is the provider's specialty?

Clinic/Center with taxonomy code 261QR0405X and a focus in Rehabilitation, Substance Use Disorder.