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Organization
LIFE BRIDGES, INC
Active
Organization
LIFE BRIDGES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANA JACKSON (CHIEF EXECUTIVE OFFICER)
(423) 472-5268
Entity
Organization
Contact information
Practice address
764 OLD CHATTANOOGA PK., CLEVELAND, TN 37311
(423) 472-5268
(423) 479-1492
Mailing address
PO BOX 29, CLEVELAND, TN 37364-0029
(423) 472-5268
(423) 479-1492
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LPC0000000617
TN
103K00000X
Behavior Analyst
—
NULL
103K00000X
Behavior Analyst
—
—
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
2083P0901X
Public Health & General Preventive Medicine Physician
—
NULL
2083P0901X
Public Health & General Preventive Medicine Physician
—
—
2084N0400X
Neurology Physician
20193
TN
225X00000X
Occupational Therapist
OT2755
TN
343900000X
Non-emergency Medical Transport (VAN)
—
NULL
363A00000X
Physician Assistant
1509
TN
Other
Enumeration date
02/13/2007
Last updated
06/04/2025
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