# BRIDGEPORT SENIOR LIVING, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** The Heritage
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255427415
- **Authorized official:** JON M. HARDER (MGR. BRIDGEPORT SENIOR LIVING, LLC)
- **Authorized official phone:** (503) 375-9016

## Contact information

- **Practice address:** RR 4 BOX 17, BRIDGEPORT, WV 26330-9509
- **Practice address phone:** (304) 842-4135
- **Mailing address:** RR 4 BOX 17, BRIDGEPORT, WV 26330-9509
- **Mailing address phone:** (304) 842-4135

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | 7 | WV | Yes |

## Other

- **Enumeration date:** 10/05/2006
- **Last updated:** 08/22/2020