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General NPI Number Information
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NPI Number | 1104265305
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Entity Type | Organization
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Legal Business Name | BRIDGING THE G.A.P.P. THROUGH AMBITION, PASSION, AND POSITIVITY, LLC
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Dates
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Enumeration Date | 06/20/2013
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 324 S ELM ST STE 300
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City | GREENSBORO
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State | NC
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Zip | 27401-2645
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Country | US
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Telephone | 336-500-0060
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Fax | 336-500-0061
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Provider Business Mailing Address
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Address Line | 324 S ELM ST STE 300
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City | GREENSBORO
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State | NC
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Zip | 27401-2645
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Country | US
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Telephone | 336-500-0060
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Fax | 336-500-0061
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | MRS. YOLANDA MCCRAY RUDISON
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Credential |
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Telephone | 336-210-6257
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | NC
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