Provider Demographics
NPI:1063055994
Name:BRIDGING THE GAP HOME CARE LLC
Entity type:Organization
Organization Name:BRIDGING THE GAP HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIDGET
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-477-3093
Mailing Address - Street 1:7404 SAN DIEGO AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63121-2147
Mailing Address - Country:US
Mailing Address - Phone:314-477-3093
Mailing Address - Fax:
Practice Address - Street 1:7404 SAN DIEGO AVE APT 2
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63121-2147
Practice Address - Country:US
Practice Address - Phone:314-477-3093
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-23
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health