Bridge 2 Home LLC

Primary specialty

Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X

Legal business name

BRIDGE 2 HOME LLC

Practice address

7231 Forestwood Dr
Independence, OH 44131-5261

Phone

(216) 647-2676

NPI assigned

Aug 29, 2024

Organization subpart

No

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

Authorized official

Name

Ms. Rayshawn T EberhardtNPI 1609727601

Title

Director of Operations

Phone

(216) 647-2676

Specialties & licenses 1

Addresses

Practitioners 1

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

• Rayshawn Eberhardt

  • Homemaker
  • Parma, OH
  • NPI 1609727601

  Single Specialty

  NPD Authorized official

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

{
    "created_epoch": "1724889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724889600000",
    "number": "1508690744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5229 W 33RD ST",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "441341217",
            "telephone_number": "216-647-2676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7231 FORESTWOOD DR",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441315261",
            "telephone_number": "216-647-2676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGE 2 HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-29",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A",
        "authorized_official_last_name": "EBERHARDT",
        "authorized_official_first_name": "RAYSHAWN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "216-647-2676",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "103TM1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Independence, OH
• Intellectual & Developmental Disabilities Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; 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.