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LIFEBRIDGE SUPPORTED LIVING LLC
NPI 1912896572
Clinic/Center in Albuquerque, NM

Active since June 30, 2025
4113 EUBANK BLVD NE STE 200D, ALBUQUERQUE, NM 87111(470) 461-7149 Get Directions Write a Review

NPPES record last updated: July 24, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Table of Contents

  1. NPI Profile Information
  2. Primary Taxonomy
  3. Secondary Taxonomies
  4. Authorized Official
  5. Frequently Asked Questions
  • Organization
  • Clinic/Center

About LIFEBRIDGE SUPPORTED LIVING LLC

This page provides the complete NPI Profile along with additional information for Lifebridge Supported Living Llc, a provider established in Albuquerque, New Mexico operating as a Clinic/center. The healthcare provider is registered in the NPI registry with number 1912896572 assigned on June 2025. The practitioner's primary taxonomy code is 261Q00000X. The provider is registered as an organization and their NPI record was last updated one year ago. The authorized official of this NPI record is Raphael Onyekachi (Excutive Director)

NPI
1912896572 Verify this NPI
Provider Name
LIFEBRIDGE SUPPORTED LIVING LLC
Entity Type
Organization
Location Address
4113 EUBANK BLVD NE STE 200D ALBUQUERQUE, NM 87111
Location Phone
(470) 461-7149
Mailing Address
4113 EUBANK BLVD NE STE 200D ALBUQUERQUE, NM 87111
Mailing Phone
(470) 461-7149
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
06-30-2025
Last Update Date
07-24-2025
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Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center

Taxonomy Code
261Q00000X
Type
Ambulatory Health Care Facilities
Taxonomy Description
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization		 License No. (State)
1253Z00000XAgencies

In Home Supportive Care

 

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

RAPHAEL ONYEKACHI

Authorized Official Title
EXCUTIVE DIRECTOR
Authorized Official Phone
(147) 046-1714

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Frequently Asked Questions

What is LIFEBRIDGE SUPPORTED LIVING LLC's NPI number?

The NPI number assigned to this healthcare provider is 1912896572, enumerated as an "organization" on June 30, 2025.

Where is the provider located?

The provider is located at 4113 EUBANK BLVD NE STE 200D ALBUQUERQUE, NM 87111 and the phone number is (470) 461-7149.

What is the provider's specialty?

Clinic/Center with taxonomy code 261Q00000X.