Provider Demographics
NPI:1215363973
Name:BRIDGES 4 LIFE, LLC
Entity Type:Organization
Organization Name:BRIDGES 4 LIFE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:WHITE-SMILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-271-1091
Mailing Address - Street 1:312 PEABODY ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-2119
Mailing Address - Country:US
Mailing Address - Phone:202-271-1091
Mailing Address - Fax:
Practice Address - Street 1:312 PEABODY ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-2119
Practice Address - Country:US
Practice Address - Phone:202-271-1091
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-25
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management