Organization
BRIDGEPORT SENIOR LIVING, LLC
Active
Other names
The Heritage
Organization subpart
No
Provider details
NPI number
Authorized official
JON M. HARDER (MGR. BRIDGEPORT SENIOR LIVING, LLC)
(503) 375-9016
Entity
Organization
Contact information
Practice address
RR 4 BOX 17, BRIDGEPORT, WV 26330-9509
(304) 842-4135
Mailing address
RR 4 BOX 17, BRIDGEPORT, WV 26330-9509
(304) 842-4135
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
7
WV
Other
Enumeration date
10/05/2006
Last updated
08/22/2020
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