# BRADFORD GUEST CARE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235179086
- **Authorized official:** MR. KEVIN C GAMBLE (OFFICER)
- **Authorized official phone:** (318) 798-2648

## Contact information

- **Practice address:** 3050 BAIRD RD, SHREVEPORT, LA 71118-3818
- **Practice address phone:** (318) 688-1010
- **Practice address fax:** (318) 688-1099
- **Mailing address:** PO BOX 52389, SHREVEPORT, LA 71135-2389
- **Mailing address phone:** (318) 798-2648
- **Mailing address fax:** (318) 798-3451

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 868 | LA | Yes |

## Other

- **Enumeration date:** 06/08/2006
- **Last updated:** 03/28/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1516546 | — | LA |