Healthcare Provider Details

I. General information

NPI: 1588103998
Provider Name (Legal Business Name): A BRIDGE FOR INDEPENDENCE HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

87 BURLEY DR
COLUMBIAVILLE MI
48421-9723
US

IV. Provider business mailing address

87 BURLEY DRIVE
COLUMBIAVILLE MI
48421
US

V. Phone/Fax

Practice location:
  • Phone: 248-392-0037
  • Fax:
Mailing address:
  • Phone: 248-392-0037
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateMI

VIII. Authorized Official

Name: MEGHAN RILEY
Title or Position: OWNER
Credential:
Phone: 248-392-0037