NPIMap

Organization Active NPI

Bridge Haven Memory Care, LLC

  • Alzheimer Center (Dementia Center)
  • Lawrence, KS
National Provider Identifier
1982070314
Registry record updated Aug 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Alzheimer Center (Dementia Center)Taxonomy code 311500000X
License
B023017 Issued in KS
Legal business name
BRIDGE HAVEN MEMORY CARE, LLC
Practice address
2147 Quail Creek Dr
Lawrence, KS 66047-2142
Phone
(785) 371-1106
NPI assigned
Aug 20, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2015

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

Authorized official

Name
Mrs. Sarah A Randolph
Title
Executive Director
Phone
(785) 371-1106

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Alzheimer Center (Dementia Center) 311500000X B023017 KS Primary

Addresses

Primary practice location

2147 Quail Creek Dr
Lawrence, KS 66047-2142

Mailing address

1126 Hilltop Dr
Lawrence, KS 66044-4530
Phone (785) 371-1106

National Provider Directory

National Provider Directory
Tax ID family
Bridge Haven Memory Care LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1440028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440028800000",
    "number": "1982070314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1126 HILLTOP DR",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660444530",
            "telephone_number": "785-371-1106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2147 QUAIL CREEK DR",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660472142",
            "telephone_number": "785-371-1106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGE HAVEN MEMORY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-20",
        "last_updated": "2015-08-20",
        "status": "A",
        "authorized_official_last_name": "RANDOLPH",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "785-371-1106",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "KS",
            "license": "B023017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2015; 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.