Organization
LIFE BRIDGE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON S SHAFFER PHD (CEO)
(330) 546-7767
Entity
Organization
Contact information
Practice address
2705 FULTON DR NW, CANTON, OH 44718-3527
(330) 546-7767
Mailing address
2705 FULTON DR NW, CANTON, OH 44718-3527
(330) 546-7767
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
107108
—
OH
Enumeration date
12/11/2020
Last updated
12/11/2020
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