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General NPI Number Information
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NPI Number | 1629994298
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Entity Type | Organization
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Legal Business Name | BRIDAVE HEALTHCARE LLC
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Dates
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Enumeration Date | 06/26/2026
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Last Update Date | 06/26/2026
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Provider Practice Location Address
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Address Line | 126 HIGHGROVE WAY
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City | DALLAS
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State | GA
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Zip | 30157-7404
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Country | US
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Telephone | 470-350-0650
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Fax | 470-300-9776
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Provider Business Mailing Address
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Address Line | 126 HIGHGROVE WAY
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City | DALLAS
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State | GA
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Zip | 30157-7404
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Country | US
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Telephone | 470-350-0650
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Fax | 470-300-9776
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Authorized Official
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Title or Position | CEO/ADMIN
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Name | GRACE ADELUGBA
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Credential |
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Telephone | 470-350-0650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 171WH0202X
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Taxonomy Name | Home Modifications Contractor
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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