Healthcare Provider Details

I. General information

NPI: 1790647246
Provider Name (Legal Business Name): BRIDGING THE GAP WELLNESS AND CARE NAVIGATION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2025
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1818 KISSINGBOWER RD
AUGUSTA GA
30904-6501
US

IV. Provider business mailing address

1818 KISSINGBOWER RD
AUGUSTA GA
30904-6501
US

V. Phone/Fax

Practice location:
  • Phone: 321-433-1145
  • Fax:
Mailing address:
  • Phone: 321-433-1145
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: TIFFANY MCCAULEY BRIDGES
Title or Position: MANAGING MEMBER
Credential:
Phone: 321-433-1145