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BRIDGE THE GAP INC NPI 1073990420


NPI Information

NPI: 1073990420
Provider Name: BRIDGE THE GAP, INC
Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization
Address:
1415 E GREEN BAY ST
SUITE 111
SHAWANO, WI
ZIP 54166
Phone: (715) 526-3791
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BRIDGE THE GAP, INC is a community behavioral health in Shawano, WI. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. BRIDGE THE GAP, INC NPI is 1073990420. The provider is registered as an organization entity type.

The provider's business location address is:

1415 E GREEN BAY ST
SUITE 111
SHAWANO, WI
ZIP 54166-879
Phone: (715) 526-3791
Fax: (715) 526-5537

The provider's authorized official is Lesley Linn Laluzerne .
The authorized official title is President and has the following contact phone number (715) 526-3791.

The enumeration date for this NPI number is 5/5/2015 and was last updated on 5/5/2015.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1251S00000XCommunity/Behavioral HealthYes

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: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.