Bridge of Care Group Home LLC

Primary specialty

Chore ProviderTaxonomy code 372500000X

Legal business name

BRIDGE OF CARE GROUP HOME LLC

Practice address

1312 Stuben Dr
Dayton, OH 45417-8252

Phone

(937) 305-6637

NPI assigned

Sep 18, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Ashlee HairstonNPI 1639862626

Title

Owner

Phone

(937) 305-6637

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Bridge of Care Homes and Maintenance Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ashlee Hairston

  • Chore Provider
  • Trotwood, OH
  • NPI 1639862626
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1694995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694995200000",
    "number": "1093593386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5108 MALIBU CT",
            "city": "TROTWOOD",
            "state": "OH",
            "postal_code": "454262353",
            "telephone_number": "937-305-6637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1312 STUBEN DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454178252",
            "telephone_number": "937-305-6637"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5108 Malibu Ct",
            "address_purpose": "LOCATION",
            "city": "Trotwood",
            "state": "OH",
            "postal_code": "454262353",
            "country_code": "US",
            "telephone_number": "937-305-6637",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BRIDGE OF CARE GROUP HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-18",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A",
        "authorized_official_last_name": "HAIRSTON",
        "authorized_official_first_name": "ASHLEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-305-6637",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "372500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chore Provider",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1639862626",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bridge of Care Homes and Maintenance",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Keith Bricking, M.D.
• Laura Gene Bricklin, MD
• Ethan Tyler Brickman, DO
• Bridge Consulting Services LLC
• Bridge Consulting Services LLC
• Amberlee Bridgeforth
• Annquinniece Bridgeman
• Paula Kent Bridgeman, LPCC
• Carla M Bridges, M.D.
• Karla Lynn Bridges

• Chore Provider in Dayton, OH
• Providers in Dayton, OH by specialty
• Chore Provider in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.