Organization
BRIDGING THE GAP SERVICES LLC
Active
Organization
BRIDGING THE GAP SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DESHAWN SMITH GROUP HOME PROVIDER (OWNER)
(786) 368-8183
Entity
Organization
Contact information
Practice address
2551 NW 47TH ST, MIAMI, FL 33142-4655
(786) 368-8183
Mailing address
550 NW 214TH ST APT 104, MIAMI, FL 33169-2177
(786) 368-8183
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
11-1248-GH
FL
Other
Enumeration date
12/08/2017
Last updated
06/20/2018
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