MEDICARE: BRIDGING THE GAP HOMECARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251E00000X	Home Health Agency
2	251F00000X	Home Infusion Agency
3	343900000X	Non-emergency Medical Transport (VAN)
4	385H00000X	Respite Care
5	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1891664694
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIDGING THE GAP HOMECARE LLC

Provider Business Mailing Address
First Line	:	1834 E BASELINE RD STE 205
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85283-1507
Country	:	US
Telephone Number	:	480-474-4668
Fax Number	:

Provider Business Practice Location Address
First Line	:	1834 E BASELINE RD STE 205
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85283-1507
Country	:	US
Telephone Number	:	480-474-4668
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MS. TYISHAL JACOBS SMITH
Credential	:
Telephone Number	:	201-702-5048

Provider Enumeration Date	:	10/31/2025
Last Update Date	:	10/31/2025

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