Organization
LIFE BRIDGE LLC
Active
Organization
LIFE BRIDGE LLC
Active
Other names
Life Bridge
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON SHAFFER PHD (CEO)
(330) 324-7785
Entity
Organization
Contact information
Practice address
3722 WHIPPLE AVE NW, CANTON, OH 44718-2934
(330) 324-7785
Mailing address
3722 WHIPPLE AVE NW, CANTON, OH 44718-2934
(330) 324-7785
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/17/2022
Last updated
10/17/2022
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