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Contact Information

BRIDGEPORT SENIOR LIVING, LLC
RR 4 BOX 17
BRIDGEPORT, WV26330-9509
 Phone: 304-842-4135
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nursing Facility/Intermediate Care Facility

313M00000X A3[10] Other Nursing Facility
Indicates primary specialty

NPI Profile & details for BRIDGEPORT SENIOR LIVING, LLC

NPI # 1255427415
LBN Legal business name BRIDGEPORT SENIOR LIVING, LLC
Authorized official JON HARDER - (MGR. BRIDGEPORT SENIOR LIVING, LLC)
Entity Organization
Organization subpart 1 No
Enumeration date 10/05/2006
Last updated 08/22/2020 - About 6 years ago
Identifiers
WV License # 7
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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