Life Bridge LLC

NPI #1710603113 in Canton, Ohio

Provider Information

NPI Number: 1710603113
Entity Type: Organization
Organization Name: Life Bridge LLC
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Oct 17, 2022
Last Updated: Oct 17, 2022

Practice Location

Address: 3722 WHIPPLE AVE NW
City: Canton
State: Ohio
ZIP Code: 44718-2934
Phone: (330) 324-7785

Authorized Official

Name: DR. JASON SHAFFER, PHD
Title: CEO
Phone: (330) 324-7785

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X	Primary

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