| NPI | 1447904842 |
|---|---|
| Other Name | BRIDGE OF LIGHT LLC |
| Entity Type | Organization |
| Authorized Contact | XANDER DANIEL FAISON Owner 405-568-1338 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 251B00000X Case Management |
| 253Z00000X In Home Supportive Care | |
| 363LA2100X Nurse Practitioner, Acute Care | |
| 251E00000X Home Health | |
| Enumeration Date | 2022-02-05 |
| Last Update Date | 2022-05-03 |