Life Bridge Services

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

LIFE BRIDGE SERVICES

Practice address

2705 Fulton Dr NW
Canton, OH 44718-3527

Phone

(330) 546-7767

NPI assigned

Dec 11, 2020

Organization subpart

No

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

Authorized official

Name

Jason S Shaffer, PHD

Title

Ceo

Phone

(330) 546-7767

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1607644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607644800000",
    "number": "1265038418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2705 FULTON DR NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447183527",
            "telephone_number": "330-546-7767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 FULTON DR NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447183527",
            "telephone_number": "330-546-7767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE BRIDGE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-11",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A",
        "authorized_official_last_name": "SHAFFER",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "330-546-7767",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "107108",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tatyanah Lewis
• Liberty House
• Jeremy Liebman, M.D.
• Teri Ann Lieser, CNS
• Life Bridge LLC
• Life Simplified, LLC
• Lifecare Family Health and Dental Center, Inc
• Lifecare Family Health and Dental Center, Inc
• Lifecare Family Health and Dental Center, Inc
• Jean Rachel Ligas, PHARMD

• In Home Supportive Care Agency in Canton, OH
• Providers in Canton, OH by specialty
• In Home Supportive Care Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2020; 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.