Healthcare Provider Details

I. General information

NPI: 1982559951
Provider Name (Legal Business Name): BRIDGING GAPS SUPPORT SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2026
Last Update Date: 03/03/2026
Certification Date: 03/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

149 DISNEY CT
OWINGS MILLS MD
21117-3232
US

IV. Provider business mailing address

149 DISNEY CT
OWINGS MILLS MD
21117-3232
US

V. Phone/Fax

Practice location:
  • Phone: 410-564-6104
  • Fax: 410-884-6760
Mailing address:
  • Phone: 410-564-6104
  • Fax: 410-884-6760

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: MR. GEORGE EDWARD MASON JR.
Title or Position: CEO
Credential:
Phone: 410-564-6104