Provider Demographics
NPI:1215683214
Name:FILLING THE GAP WITH HOPE
Entity type:Organization
Organization Name:FILLING THE GAP WITH HOPE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAZELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-755-9748
Mailing Address - Street 1:16411 INVERMERE AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44128-1307
Mailing Address - Country:US
Mailing Address - Phone:216-633-4121
Mailing Address - Fax:
Practice Address - Street 1:16411 INVERMERE AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44128-1307
Practice Address - Country:US
Practice Address - Phone:216-633-4121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-28
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health