MEDICARE: LONDYNNS BRIDGE AFH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	311ZA0620X	Adult Care Home Facility

General Provider Information

NPI Number	:	1487509576
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LONDYNNS BRIDGE AFH LLC

Provider Business Mailing Address
First Line	:	4230 W LANCASTER AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53209-5239
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4230 W LANCASTER AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53209-5239
Country	:	US
Telephone Number	:	262-894-9124
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TARNESHA HUGHES
Credential	:
Telephone Number	:	262-894-9124

Provider Enumeration Date	:	03/03/2026
Last Update Date	:	03/03/2026

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