Organization
BRIDGE HAVEN MEMORY CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SARAH A RANDOLPH (EXECUTIVE DIRECTOR)
(785) 371-1106
Entity
Organization
Contact information
Practice address
2147 QUAIL CREEK DR, LAWRENCE, KS 66047-2142
(785) 371-1106
Mailing address
1126 HILLTOP DR, LAWRENCE, KS 66044-4530
(785) 371-1106
Taxonomy
Speciality
Code
Description
License number
State
311500000X
Alzheimer Center (Dementia Center)
Primary
B023017
KS
Other
Enumeration date
08/20/2015
Last updated
08/20/2015
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