Organization
LIFEBRIDGE SUPPORTED LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAPHAEL ONYEKACHI (EXCUTIVE DIRECTOR)
(147) 046-1714
Entity
Organization
Contact information
Practice address
4113 EUBANK BLVD NE STE 200D, ALBUQUERQUE, NM 87111-3482
(470) 461-7149
Mailing address
4113 EUBANK BLVD NE STE 200D, ALBUQUERQUE, NM 87111-3482
(470) 461-7149
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
06/30/2025
Last updated
07/24/2025
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