Organization
NAZARETH COMMUNITY BRIDGE, LLC
Active
Other names
NAZARETH COMMUNITY BRIDGE, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
CLAVER NDATABAYE (OWNER)
(207) 420-7669
Entity
Organization
Contact information
Practice address
15170 TROXEL DR E APT 302, NOBLESVILLE, IN 46060-5817
(207) 420-7669
Mailing address
15170 TROXEL DR E APT 302, NOBLESVILLE, IN 46060-5817
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/23/2021
Last updated
12/23/2021
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