| NPI | 1710603113 |
|---|---|
| Doing Business As | LIFE BRIDGE |
| Entity Type | Organization |
| Authorized Contact | JASON SHAFFER CEO 330-324-7785 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2022-10-17 |
| Last Update Date | 2022-10-17 |