| NPI | 1710421896 |
|---|---|
| Doing Business As | STONERISE BRIDGEPORT |
| Entity Type | Organization |
| Authorized Contact | LAWRENCE A PACK Manager 304-343-1950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Additional Taxonomies | 313M00000X Nursing Facility/Intermediate Care Facility |
| Enumeration Date | 2016-12-08 |
| Last Update Date | 2022-05-18 |