{"npi":"1922006923","type":"NPI-2","status":"active","name":{"display":"Lifebridge Community Services, Inc.","other":[],"organization_name":"LIFEBRIDGE COMMUNITY SERVICES, INC.","authorised_official":"Frank Farias"},"specialty":{"primary_taxonomy":"261QM0801X","primary_taxonomy_description":"Mental Health Clinic/Center (Including Community Mental Health Center)","slug":"mental-health-clinic-center-including-community-mental-health-center","schema_org_specialty":null,"all":[{"code":"261QM0801X","description":"Mental Health Clinic/Center (Including Community Mental Health Center)","primary":false,"state":null,"license":null},{"code":"261QM0801X","description":"Mental Health Clinic/Center (Including Community Mental Health Center)","primary":true,"state":"CT","license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"475 CLINTON AVE","city":"BRIDGEPORT","state":"CT","postal_code":"066051700","country_code":"US","phone":"2033684291","fax":"2033689167"},{"purpose":"MAILING","street_1":"475 CLINTON AVE","city":"BRIDGEPORT","state":"CT","postal_code":"066051700","country_code":"US","phone":"2033684291","fax":"2033689167"}],"license":null,"identifiers":[{"type_code":"05","label":"Medicaid","value":"004069985","state":"CT","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20040323000475","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"CT","pac_id":"4981595618"}]},"enumeration_date":"2005-07-13","last_updated":"2020-11-18","_meta":{"source":"NPPES","snapshot_date":"2020-11-18","doc_url":"https://findmynpi.com/api"}}