Organization
BRIDGING LIVES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BETTY ANN STEVENS NURSE PRACTITIONER (LICENSEE)
(909) 841-3513
Entity
Organization
Contact information
Practice address
12416 PRAIRIE WIND TRL, RANCHO BELAGO, CA 92555-5405
(909) 841-3513
(951) 924-7334
Mailing address
12416 PRAIRIE WIND TRL, RANCHO BELAGO, CA 92555-5405
(909) 841-3513
(951) 924-7334
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
336425538
CA
310400000X
Assisted Living Facility
336425852
CA
Other
Enumeration date
01/22/2015
Last updated
01/22/2015
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