Organization
BRIDGING THE GAP SERIVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MELODY A MCCREARY MHS CSC-AD (ADMINISTRATOR)
(240) 550-2514
Entity
Organization
Contact information
Practice address
2511 EUTAW PL STE 204, BALTIMORE, MD 21217-5202
(410) 528-8692
(410) 528-8675
Mailing address
7902 OLD BRANCH AVE STE 204, CLINTON, MD 20735-1627
(240) 318-5790
(240) 318-3551
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
SC1761
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
842250
—
MD
Enumeration date
10/17/2014
Last updated
01/29/2019
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