Organization
LIFE BRIDGES, INC.
Active
Other names
McIntire House
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUCAS QUEEN (CEO)
(423) 472-5268
Entity
Organization
Contact information
Practice address
207 KILE LAKE ROAD, CLEVELAND, TN 37323
(423) 478-7700
(423) 478-7772
Mailing address
PO BOX 29, CLEVELAND, TN 37364-0029
(423) 472-5268
(423) 479-1492
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3722363
—
TN
Enumeration date
01/07/2011
Last updated
06/04/2025
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