Provider Demographics
NPI:1497586853
Name:BUILDING LOVING BRIDGES HOME CARE LLC
Entity type:Organization
Organization Name:BUILDING LOVING BRIDGES HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TAKEELA
Authorized Official - Middle Name:
Authorized Official - Last Name:CLEMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-456-7519
Mailing Address - Street 1:103 S FLORISSANT RD STE 7
Mailing Address - Street 2:
Mailing Address - City:FERGUSON
Mailing Address - State:MO
Mailing Address - Zip Code:63135-2733
Mailing Address - Country:US
Mailing Address - Phone:314-484-9813
Mailing Address - Fax:
Practice Address - Street 1:103 S FLORISSANT RD STE 7
Practice Address - Street 2:
Practice Address - City:FERGUSON
Practice Address - State:MO
Practice Address - Zip Code:63135-2733
Practice Address - Country:US
Practice Address - Phone:314-484-9813
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health