MEDICARE: BRIDGING THE GAP ADC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA0600X	Adult Day Care Clinic/Center

General Provider Information

NPI Number	:	1215682174
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIDGING THE GAP ADC

Provider Business Mailing Address
First Line	:	909 TALBOTTON RD STE C
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31904-8851
Country	:	US
Telephone Number	:	706-780-1024
Fax Number	:	706-505-1128

Provider Business Practice Location Address
First Line	:	909 TALBOTTON RD STE C
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31904-8851
Country	:	US
Telephone Number	:	706-780-1024
Fax Number	:	706-505-1128

Authorized Official
Title or Position	:	RN/DIRECTOR
Name	:	REGINA CRAWFORD
Credential	:	RN
Telephone Number	:	334-560-6345

Provider Enumeration Date	:	02/18/2022
Last Update Date	:	08/30/2022

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Directions to “BRIDGING THE GAP ADC ” Practice Location

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