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BRIDGING THE GAP RESIDENTIAL SERVICES LLC NPI 1568651602


NPI Information

NPI: 1568651602
Provider Name: BRIDGING THE GAP RESIDENTIAL SERVICES, LLC
Classification: Day Training, Developmentally Disabled Services - 251C00000X
Entity Type: Organization

CLIA Number: 34D2054997

Address:
2945 S MIAMI BLVD
SUITE 114
DURHAM, NC
ZIP 27703
Phone: (919) 641-8378
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BRIDGING THE GAP RESIDENTIAL SERVICES, LLC is a day training developmentally disabled services in Durham, NC. The provider is these agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning. BRIDGING THE GAP RESIDENTIAL SERVICES, LLC NPI is 1568651602. The provider is registered as an organization entity type.

The provider's business location address is:

2945 S MIAMI BLVD
SUITE 114
DURHAM, NC
ZIP 27703-024
Phone: (919) 641-8378
Fax: (919) 964-3364

The provider's authorized official is Marshelia Benton .
The authorized official title is Owner and has the following contact phone number (919) 641-8378.

The CLIA number assigned to this NPI record is 34D2054997 - other - adult care home with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/15/2007 and was last updated on 4/14/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1310400000XAssisted Living FacilityMHL-032-451NORTH CAROLINANo
2310400000XAssisted Living FacilityMHL-032-419NORTH CAROLINANo
3251C00000XDay Training, Developmentally Disabled ServicesMHL-032-520NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
13418478MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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