# BRIDGEPORT HEALTH CARE CENTER, LLC

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

## Provider details

- **NPI number:** 1336524586
- **Authorized official:** MR. TODD R JONES (MANAGER)
- **Authorized official phone:** (304) 344-1623

## Contact information

- **Practice address:** RT 4 BOX 17, BRIDGEPORT, WV 26330-9509
- **Practice address phone:** (304) 842-4195
- **Practice address fax:** (304) 842-4398
- **Mailing address:** PO BOX 532, CHARLESTON, WV 25322-0532
- **Mailing address phone:** (304) 344-1623
- **Mailing address fax:** (304) 556-9165

## Taxonomy

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

## Other

- **Enumeration date:** 07/29/2015
- **Last updated:** 07/29/2015