# LIFEBRIDGE HEALTHCARE LLC

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

## Provider details

- **NPI number:** 1649091976
- **Authorized official:** MR. BYRON KIRIIBWA (MANAGER)
- **Authorized official phone:** (857) 615-0337

## Contact information

- **Practice address:** 111 HILL ST APT 11, STONEHAM, MA 02180-3734
- **Practice address phone:** (857) 615-0337
- **Mailing address:** 111 HILL ST APT 11, STONEHAM, MA 02180-3734
- **Mailing address phone:** (857) 615-0337

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |
| 251G00000X | Community Based Hospice Care Agency | — | NULL | — |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | — |
| 311Z00000X | Custodial Care Facility | — | NULL | — |
| 314000000X | Skilled Nursing Facility | — | NULL | — |
| 385H00000X | Respite Care | — | NULL | — |

## Other

- **Enumeration date:** 10/19/2024
- **Last updated:** 10/19/2024