Bridge 2 Life - El Nido, LLC

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

Legal business name

BRIDGE 2 LIFE - EL NIDO, LLC

Practice address

1637 El Nido Ave
Perris, CA 92571-3700

Phone

(951) 928-0494

Fax

(951) 928-0494

NPI assigned

Dec 22, 2014

Organization subpart

No

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

Authorized official

Name

Vivian Bazley

Title

Managing Member

Phone

(951) 928-0494

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1419206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419206400000",
    "number": "1821486093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1637 EL NIDO AVE",
            "city": "PERRIS",
            "state": "CA",
            "postal_code": "925713700",
            "telephone_number": "951-928-0494",
            "fax_number": "951-928-0494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1637 EL NIDO AVE",
            "city": "PERRIS",
            "state": "CA",
            "postal_code": "925713700",
            "telephone_number": "951-928-0494",
            "fax_number": "951-928-0494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGE 2 LIFE - EL NIDO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-22",
        "last_updated": "2014-12-22",
        "status": "A",
        "authorized_official_last_name": "BAZLEY",
        "authorized_official_first_name": "VIVIAN",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "951-928-0494"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Breanna Mone Brazier, DOULA/ CLE
• Breaking Free of Addiction
• Roswitha Elisabeth Breuer, MD
• Almond Brewer
• Jonathon Michael Brewer
• Bridge 2 Life Healthcare, Inc.
• Bridge 2 Life-Addison, LLC (Panda Way)
• Kelli Brower, LCSW
• Camille T Brown
• Nikisha Simone Brown, LCSW

• Nursing Facility/Intermediate Care Facility in Perris, CA
• Providers in Perris, CA by specialty
• Nursing Facility/Intermediate Care Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2014; 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.