BRIDGEPORT SENIOR LIVING, LLC


Address: Rr 4 Box 17, Bridgeport, WV 26330-9509
Phone: 3048424135

BRIDGEPORT SENIOR LIVING, LLC (NPI# 1255427415) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1255427415
Entity Type Organization
Organization Name BRIDGEPORT SENIOR LIVING, LLC
Other Organization Name THE HERITAGE
Practice Address Rr 4 Box 17
Bridgeport
WV 26330-9509
Practice Telephone 3048424135
Mailing Telephone 3048424135
Enumeration Date 2006-10-05
Last Update Date 2020-08-22
Authorized Official Name JON M. HARDER (MGR. BRIDGEPORT SENIOR LIVING, LLC)
Authorized Official Telephone 5033759016
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 313M00000X Nursing Facility/Intermediate Care Facility 7 WV Nursing & Custodial Care Facilities

Other Provider/Organization Names

Other Name Type Code
The Heritage Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1043429301 Bridgeport Senior Living, LLC Assisted Living Facility Rr 4 Box 17, Bridgeport, WV 26330-9509 2007-05-22

Office Location

Street Address RR 4 BOX 17
City BRIDGEPORT
State WV
Zip Code 26330-9509

Providers in the same location

NPI Name Taxonomy Address Enumeration
1043429301 Bridgeport Senior Living, LLC Assisted Living Facility Rr 4 Box 17, Bridgeport, WV 26330-9509 2007-05-22

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1992303036 Gage Mackenzie Chichester Nurse Anesthetist, Certified Registered 2673 Medical Park Drive, Bridgeport, WV 26330 2020-10-12
1851914105 Melany Langhurst Social Worker 64 Professional Place, Suite 102, Bridgeport, WV 26330 2020-05-21
1245704980 Adam Christopher Stonestreet Social Worker Community Care of Bridgeport, 65 Professional Place, Bridgeport, WV 26330 2019-01-16
1588146658 Bridgeport Physical Therapy Services, Inc. Occupational Therapist 25 Sweetbrier Lane, Suite 105, Bridgeport, WV 26330 2018-09-05
1275040685 White Oaks Assisted Living Assisted Living Facility 140 Professional Place White Oaks, Bridgeport, WV 26330 2018-01-08
1275049371 Regional Eye Associates, Inc Ophthalmology 220 Southview Drive, Bridgeport, WV 26330 2017-12-27
1528586187 Savanna Tamia Brown Social Worker 65 Professinal Place Suites 101,102103, Bridgeport, WV 26330 2017-09-05
1184079642 Karla Kay Rinehart Social Worker 27 Trovato St., Suite 103, Bridgeport, WV 26330 2016-05-03
1396176756 Willo Group LLC Pharmacy 460 E. Main Street, Bridgeport, WV 26330 2013-12-10
1891031878 Sherri Michelle Dobson Occupational Therapy Assistant 1000 Maplewood Dr, Bridgeport, WV 26330 2012-12-20
Find all providers in zip 26330

Taxonomy Information

Taxonomy Code 313M00000X
Grouping Nursing & Custodial Care Facilities
Classification Nursing Facility/Intermediate Care Facility

Taxonomy Definition

An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.
Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1336524586 Bridgeport Health Care Center, LLC Nursing Facility/Intermediate Care Facility Rt 4 Box 17, Bridgeport, WV 26330-9509 2015-07-29
1861597114 Jackson County Healthcare Authority Nursing Facility/Intermediate Care Facility 47065 Alabama Hwy 277, Bridgeport, AL 35740 2006-09-13
1528022886 Bridgeport Care Center, Inc Nursing Facility/Intermediate Care Facility 102 W Cates St, Bridgeport, TX 76426-2709 2006-04-13
1710421896 Bridgeport Center LLC Nursing Facility/Intermediate Care Facility 41 Crestview Ter, Bridgeport, WV 26330-1010 2016-12-08
1891034112 Kristie Lynn Komorowski Nursing Facility/Intermediate Care Facility 415 Benedum Dr, Bridgeport, WV 26330-1503 2013-02-06

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1629453766 Rainelle Center LLC Nursing Facility/Intermediate Care Facility 276 Pennsylvania Ave, Rainelle, WV 25962-1177 2015-07-29
1558754507 Lewisburg Center LLC Nursing Facility/Intermediate Care Facility 979 Rocky Hill Rd, Ronceverte, WV 24970-8028 2015-03-16
1467845412 Wellsburg Center LLC Nursing Facility/Intermediate Care Facility 70 Valley Haven Dr, Wellsburg, WV 26070-2625 2015-03-16
1508254319 Mary Bird Nursing Facility/Intermediate Care Facility 590 North Poplar Fork Rd, Hurricane, WV 25526-9434 2014-12-31
1952536377 Springfield Center LLC Nursing Facility/Intermediate Care Facility 10797 Seneca Trl S, Lindside, WV 24951-7345 2009-05-29
1720281975 Pleasant Valley Nursing and Rehabilitation Center, Inc. Nursing Facility/Intermediate Care Facility 640 Sandhill Rd, Pt Pleasant, WV 25550-2163 2007-06-06
1194816025 Lakin Hospital Nursing Facility/Intermediate Care Facility 1 Bateman Cir, Lakin, WV 25287-9784 2006-09-27
1922100031 Morgantown Healthcare Corp Nursing Facility/Intermediate Care Facility 30 Vandervort Dr, Morgantown, WV 26505 2006-09-01
1417963000 Wvdhhr John Manchin Sr Health Care Center Nursing Facility/Intermediate Care Facility 401 Guffey Street, Fairmont, WV 26554 2006-08-01
1750338281 Sunbridge Putnam Health Care LLC Nursing Facility/Intermediate Care Facility 300 Seville Rd, Hurricane, WV 25526-9206 2006-05-30
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Competitor

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City BRIDGEPORT
Zip Code 26330

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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