Organization
BRIDGE THE GAP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. QUINCY SANDERS (EXECUTIVE DIRECTOR)
(702) 505-3635
Entity
Organization
Contact information
Practice address
9811 W CHARLESTON BLVD, STE 2538, LAS VEGAS, NV 89117-7528
(702) 505-3635
Mailing address
9811 W CHARLESTON BLVD, STE 2538, LAS VEGAS, NV 89117-7528
(702) 505-3635
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
01/09/2010
Last updated
10/07/2015
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