Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Psychiatric/Mental Health |
363LP0808X | 50 | Nurse Practitioner | |
Health Service |
261QH0100X | |||
Home Health |
251E00000X | A4[11] | Home Health Agency |
| NPI Number | 1952104622 |
| LBN Legal business name | VITA BRIDGE HEALTH LLC |
| Authorized official | OLAJUMOKE JONGBO - (RN/PMHNP) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 03/28/2025 |
| Last updated | 04/15/2025 - More than a year ago |
| Identifiers | n/a |
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