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General NPI Number Information
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NPI Number | 1386704260
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Entity Type | Organization
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Legal Business Name | CAREBRIDGE ASSISTED LIVING
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 09/05/2013
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Provider Practice Location Address
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Address Line | 34 MCDANIEL DR
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City | JACKSONVILLE
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State | NC
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Zip | 28546-6942
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Country | US
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Telephone | 910-347-1300
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Fax | 910-347-2111
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Provider Business Mailing Address
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Address Line | 30 DEPOT ST W
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City | CHRISTIANSBURG
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State | VA
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Zip | 24073-2930
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Country | US
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Telephone | 540-394-2200
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Fax | 540-394-2200
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Authorized Official
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Title or Position | COMPTROLLER
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Name | SUSAN OOST
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Credential |
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Telephone | 540-394-2200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | HAL067005
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License Number State | NC
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