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Organization
BRIDGE OF LIFE ASSISTED LIVING LLC
Active
Organization
BRIDGE OF LIFE ASSISTED LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FANTA JALATA (MANAGER)
(612) 501-6123
Entity
Organization
Contact information
Practice address
7652 184TH ST W, LAKEVILLE, MN 55044-4834
(612) 501-6123
Mailing address
7652 184TH ST W, LAKEVILLE, MN 55044-4834
(612) 501-6123
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
01/16/2023
Last updated
01/16/2023
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