# BRIDGE HAVEN MEMORY CARE, LLC

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

## Provider details

- **NPI number:** 1982070314
- **Authorized official:** MRS. SARAH A RANDOLPH (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (785) 371-1106

## Contact information

- **Practice address:** 2147 QUAIL CREEK DR, LAWRENCE, KS 66047-2142
- **Practice address phone:** (785) 371-1106
- **Mailing address:** 1126 HILLTOP DR, LAWRENCE, KS 66044-4530
- **Mailing address phone:** (785) 371-1106

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311500000X | Alzheimer Center (Dementia Center) | B023017 | KS | Yes |

## Other

- **Enumeration date:** 08/20/2015
- **Last updated:** 08/20/2015