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General NPI Number Information
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NPI Number | 1619307840
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Entity Type | Organization
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Legal Business Name | BRIDGING THE GAP HOME SERVICES, LLC
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Dates
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Enumeration Date | 11/25/2013
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Last Update Date | 11/26/2013
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Provider Practice Location Address
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Address Line | 610 N LAFAYETTE ST
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City | FLORISSANT
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State | MO
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Zip | 63031-4916
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Country | US
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Telephone | 314-324-2859
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Fax | 314-427-2105
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Provider Business Mailing Address
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Address Line | 3643 THOMAS AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63114-4120
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/EXECUTIVE DIRECTOR
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Name | CATHERINE N. SMITH
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Credential |
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Telephone | 314-324-2859
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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