Bridging the Gap Services LLC

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

License

11-1248-GH Issued in FL

Legal business name

BRIDGING THE GAP SERVICES LLC

Practice address

2551 NW 47TH St
Miami, FL 33142-4655

Phone

(786) 368-8183

NPI assigned

Dec 8, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Deshawn Smith, GROUP HOME PROVIDER

Title

Owner

Phone

(786) 368-8183

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1512691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529452800000",
    "number": "1861907115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 NW 214TH ST APT 104",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331692177",
            "telephone_number": "786-368-8183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2551 NW 47TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331424655",
            "telephone_number": "786-368-8183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGING THE GAP SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-08",
        "last_updated": "2018-06-20",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DESHAWN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-368-8183",
        "authorized_official_credential": "GROUP HOME  PROVIDER"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "FL",
            "license": "11-1248-GH",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.