Organization · NPI-2

Bridging The Gap With Life Skills

Residential Treatment Facility, Emotionally Disturbed Children · Raleigh, NC

NPI number1659412997
StatusActive
Last updated in NPPESJul 20, 2007

Details

NPI
1659412997
Entity type
Organization (NPI-2)
Legal business name
Bridging The Gap With Life Skills
Organization subpart
Yes
Enumeration date
Feb 9, 2007
Last updated
Jul 20, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
322D00000X Residential Treatment Facility, Emotionally Disturbed ChildrenMHL092571NCYes

Practice location

2507 Blackwolf Run Ln
Raleigh, NC 27604-5425

Phone 919-250-9546 · Fax 919-250-7569

Mailing address

204 N Person St
Raleigh, NC 27601-1047

Phone 919-833-2544 · Fax 919-833-0939

Authorized official

Tammy Worthington
Quality Servies Director
9198332544

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