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General NPI Number Information
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NPI Number | 1992655997
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Entity Type | Organization
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Legal Business Name | THE BRIDGE HOUSE LLC
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Dates
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Enumeration Date | 01/29/2026
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Last Update Date | 01/29/2026
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Provider Practice Location Address
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Address Line | 18629 ORLEANS ST
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City | DETROIT
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State | MI
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Zip | 48203-2149
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Country | US
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Telephone | 313-370-0683
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Fax |
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Provider Business Mailing Address
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Address Line | 19100 PARKSIDE ST
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City | DETROIT
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State | MI
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Zip | 48221-1833
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Country | US
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Telephone | 313-370-0683
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | SONYA VALJEAN SMITH
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Credential | MBA
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Telephone | 313-370-0683
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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