Provider Demographics
NPI:1215531959
Name:BRIDGING THE GAP EARLY INTERVENTION CENER, LLC
Entity type:Organization
Organization Name:BRIDGING THE GAP EARLY INTERVENTION CENER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EARLY INTERVENTION SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:C
Authorized Official - Last Name:CURLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-499-0499
Mailing Address - Street 1:1042 JIMSON CIR SE
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30013-2054
Mailing Address - Country:US
Mailing Address - Phone:470-331-5809
Mailing Address - Fax:
Practice Address - Street 1:1042 JIMSON CIR SE
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30013-2054
Practice Address - Country:US
Practice Address - Phone:470-331-5809
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-23
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care