Provider Demographics
NPI:1073642971
Name:BRIDGING THE GAP IN HOME AIDE SERVICE, INC.
Entity Type:Organization
Organization Name:BRIDGING THE GAP IN HOME AIDE SERVICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:
Authorized Official - Last Name:PENLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-389-8350
Mailing Address - Street 1:32 TEAKS DR
Mailing Address - Street 2:
Mailing Address - City:HAYESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28904-5395
Mailing Address - Country:US
Mailing Address - Phone:828-389-8350
Mailing Address - Fax:828-389-9064
Practice Address - Street 1:32 TEAKS DR
Practice Address - Street 2:
Practice Address - City:HAYESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28904-5395
Practice Address - Country:US
Practice Address - Phone:828-389-8350
Practice Address - Fax:828-389-9064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3372251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health