Organization
BRIDGE HOSPICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK H POWELL MSN RN (DIRECTOR OF OPERATIONS)
(928) 493-4410
Entity
Organization
Contact information
Practice address
1695 MESQUITE AVE STE 202, LAKE HAVASU CITY, AZ 86403-5687
(928) 493-4410
(928) 302-1907
Mailing address
1695 MESQUITE AVE STE 202, LAKE HAVASU CITY, AZ 86403-5687
(928) 493-4410
(928) 302-1907
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
—
—
Other
Enumeration date
04/07/2021
Last updated
04/07/2021
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