LIFE BRIDGES, INC.


Address: 207 Kile Lake Road, Cleveland, TN 37323
Phone: 4234787700

LIFE BRIDGES, INC. (NPI# 1679877518) 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) 1679877518
Entity Type Organization
Organization Name LIFE BRIDGES, INC.
Other Organization Name MCINTIRE HOUSE
Practice Address 207 Kile Lake Road
Cleveland
TN 37323
Mailing Address Po Box 29
Cleveland
TN 37364-0029
Practice Telephone 4234787700
Practice Fax Number 4234787772
Mailing Telephone 4234725268
Mailing Fax Number 4234791492
Enumeration Date 2011-01-07
Last Update Date 2013-03-13
Authorized Official Name DR. LUCAS QUEEN (CEO)
Authorized Official Telephone 4234725268
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 315P00000X Intermediate Care Facility, Mentally Retarded Nursing & Custodial Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
TN 3722363 05

Other Provider/Organization Names

Other Name Type Code
McIntire House Other Name - Individual/Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1376847251 Life Bridges, Inc. Intermediate Care Facility, Mentally Retarded 209 Kile Lake Road, Cleveland, TN 37323 2011-01-06

Other Data Sources

Entity Type Entity Name Entity Address
System for Award Management (SAM) Entities LIFE BRIDGES, INC. 764 Old Chattanooga Pike Sw, Cleveland, TN 37311-8517

Office Location

Street Address 207 KILE LAKE ROAD
City CLEVELAND
State TN
Zip Code 37323

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1477066082 Quadmed Medical Clinics of Wisconsin, S.c. D/b/a Quadmed Medical Group Registered Nurse 2525 Benton Pike Ne, Cleveland, TN 37323 2017-11-06
1376847251 Life Bridges, Inc. Intermediate Care Facility, Mentally Retarded 209 Kile Lake Road, Cleveland, TN 37323 2011-01-06
1508084302 Karen Elizabeth Gannon Nurse Practitioner 11111 Doctor's Office Tower, 2200 Children's Way, Nashville, TN 37323 2007-04-24
1235353566 Melissa D Townsend Specialist/Technologist, Other 120 Fern Drive, Cleveland, TN 37323 2007-04-11
1306965686 David Wayne Miolen Dentist 2648 Apd 40, Cleveland, TN 37323 2007-03-28
1780751933 Linda Fay Wooten Driver 2259 Spring Place Rd Se, Cleveland, TN 37323 2006-11-30
1487134482 Kristy Alese Henegar Nurse Practitioner 1420 Fritz St Se, Cleveland, TN 37323 2018-08-19
1417577537 Eduardo Trevino Family Medicine 3009 Midfield Cir Se, Cleveland, TN 37323-0554 2020-04-18
1831339589 Lyle Foster Johnson Occupational Therapy Assistant 2657 Apd 40, Cleveland, TN 37323-0696 2009-02-20
1255434965 Tennessee Cvs Pharmacy LLC Pharmacy 2651 Apd 40, S Forke Plaza, Cleveland, TN 37323-0696 2006-09-07
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Taxonomy Information

Taxonomy Code 315P00000X
Grouping Nursing & Custodial Care Facilities
Classification Intermediate Care Facility, Mentally Retarded

Taxonomy Definition

(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.
Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c).

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1700201118 Tamara M Cowans Intermediate Care Facility, Mentally Retarded 9409 Easton Ave, Cleveland, OH 44104-5417 2014-02-21
1376847251 Life Bridges, Inc. Intermediate Care Facility, Mentally Retarded 209 Kile Lake Road, Cleveland, TN 37323 2011-01-06
1801001524 Cuyahoga County Bd. of Mrdd Intermediate Care Facility, Mentally Retarded 6809 Smith Rd, Cleveland, OH 44130-2681 2007-05-14
1164636007 Cuyahoga County Bd. of Mrdd Intermediate Care Facility, Mentally Retarded 2440 W 14th St, Cleveland, OH 44113-4406 2007-05-10
1427262369 Cuyahoga County Bd. of Mrdd Intermediate Care Facility, Mentally Retarded 2980 Van Aken Blvd, Cleveland, OH 44120-2862 2007-05-10
1407060684 Cuyahoga County Bd of Mrdd Intermediate Care Facility, Mentally Retarded 1905 Green Rd, Cleveland, OH 44112-1021 2007-05-09
1487868790 Cuyahoga County Bd of Mrdd Intermediate Care Facility, Mentally Retarded 4248 W 35th St, Cleveland, OH 44109-3108 2007-05-09
1336353432 Cuyahoga County Bd of Mrdd Intermediate Care Facility, Mentally Retarded 4520 Monticello Blvd, Cleveland, OH 44143-2840 2007-05-09
1104039924 Cuyahoga County Bd. of Mrdd Intermediate Care Facility, Mentally Retarded 19080 Bagley Rd, Cleveland, OH 44130-3310 2007-05-08
1912121005 New Avenues To Independence, Inc. Intermediate Care Facility, Mentally Retarded 17608 Euclid Ave, Cleveland, OH 44112-1216 2007-04-12
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Competitor

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City CLEVELAND
Zip Code 37323

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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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