Senior Bridge Llc

LBN: Senior Bridge Llc
Senior Bridge Llc is an health care organization with primary practice located at 11204 W Greenfield Ave , West Allis WI 53214-2240. The organization recently has only one registered license in Agencies / Home Health, which is considered as the primary health care specialty. Senior Bridge Llc can be contacted via phone (414) 988-2228, or through Coburn, Kentocc L via phone (414) 988-2228.

Contact Information

Primary practice address
11204 W Greenfield Ave West Allis WI 53214-2240
Phone: (414) 988-2228
Fax: (414) 988-2660
Website:
Map and Directions
Authorized official contact:
Name: Coburn, Kentocc L
Phone: (414) 988-2228

Health care specialties

SpecialtyCodeLicense #State
Agencies / Home Health 251E00000X

Profile Details

NPI number 1104412295
LBN Legal business name Senior Bridge Llc
DBA Doing business as
Authorized official Coburn, Kentocc L
Entity Organization
Organization subpart 1 No
Enumeration date Dec 14th, 2020
Last updated Dec 14th, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104412295 NPPES
Wisconsin MEDICAID 100091399

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