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NPI 1083426985

NPI 1083426985 : NURSE BRIDGE HOME SUPPORT LLC : WELLINGTON, FL

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General NPI Number Information
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    NPI Number           |    1083426985
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    Entity Type          |    Organization 
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    Legal Business Name  |    NURSE BRIDGE HOME SUPPORT LLC 
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Dates
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    Enumeration Date     |    01/27/2025
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    Last Update Date     |    01/27/2025
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Provider Practice Location Address
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    Address Line         |    2325 WELLINGTON GREEN DR APT 201 
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    City                 |    WELLINGTON
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    State                |    FL
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    Zip                  |    33414-9315
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    Country              |    US
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    Telephone            |    561-914-4194
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2325 WELLINGTON GREEN DR APT 201 
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    City                 |    WELLINGTON
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    State                |    FL
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    Zip                  |    33414-9315
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     DANIELLE  JOHNSON 
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    Credential           |    
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    Telephone            |    561-914-4194
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    251E00000X
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    Taxonomy Name        |    Home Health Agency
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    License Number       |    
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    License Number State |    
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