# LIFE BRIDGE, LLC

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

## Provider details

- **NPI number:** 1508114786
- **Authorized official:** MRS. ERICA ELIZABETH KOONTZ RN (RN/DIRECTOR)
- **Authorized official phone:** (785) 806-3973

## Contact information

- **Practice address:** 1664 SW 28TH ST, TOPEKA, KS 66611-1673
- **Practice address phone:** (785) 806-3973
- **Mailing address:** 1664 SW 28TH ST, TOPEKA, KS 66611-1673
- **Mailing address phone:** (785) 806-3973

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 13-109274-012 | KS | Yes |

## Other

- **Enumeration date:** 08/21/2012
- **Last updated:** 08/21/2012