Provider Demographics
NPI:1851543151
Name:LIFE BRIDGES, INC
Entity Type:Organization
Organization Name:LIFE BRIDGES, INC
Other - Org Name:CATE HOUSE
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-303-1933
Mailing Address - Street 1:PO BOX 29
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37364-0029
Mailing Address - Country:US
Mailing Address - Phone:423-472-5268
Mailing Address - Fax:423-479-1492
Practice Address - Street 1:3745 ADKISSON DR NW
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37312-3268
Practice Address - Country:US
Practice Address - Phone:423-479-4976
Practice Address - Fax:423-479-1492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-17
Last Update Date:2023-04-26
Deactivation Date:2022-02-18
Deactivation Code:
Reactivation Date:2022-07-19
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual DisabilitiesGroup - Single Specialty