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General NPI Number Information
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NPI Number | 1184488462
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Entity Type | Organization
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Legal Business Name | NEW BRIDGE HOMES LLC
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Dates
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Enumeration Date | 02/07/2024
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Last Update Date | 02/26/2024
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Provider Practice Location Address
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Address Line | 2847 KNOLLWOOD DR SE
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City | ROCHESTER
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State | MN
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Zip | 55904-5975
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Country | US
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Telephone | 507-884-7103
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Fax | 323-978-1943
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Provider Business Mailing Address
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Address Line | 1500 1ST AVE NE STE 219
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City | ROCHESTER
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State | MN
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Zip | 55906-4170
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Country | US
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Telephone | 507-884-7103
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Fax | 323-978-1943
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Authorized Official
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Title or Position | OWNER
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Name | SADIA HASAN
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Credential | RN
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Telephone | 507-884-7103
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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