Healthcare Provider Details

I. General information

NPI: 1922828797
Provider Name (Legal Business Name): BRIDGING GAPS SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2024
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

598 CHARLES ST
PROVIDENCE RI
02904-1359
US

IV. Provider business mailing address

598 CHARLES ST
PROVIDENCE RI
02904-1359
US

V. Phone/Fax

Practice location:
  • Phone: 774-520-6927
  • Fax:
Mailing address:
  • Phone: 774-520-6927
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: ALEXANDRIA YOUNG
Title or Position: OWNER
Credential:
Phone: 774-520-6927