Provider Demographics
NPI:1114458577
Name:BRIDGING WATERS TOGETHER, LLC
Entity Type:Organization
Organization Name:BRIDGING WATERS TOGETHER, LLC
Other - Org Name:BRIDGING WATERS PCA & TRANSPORTATION SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARRA
Authorized Official - Middle Name:VANAE
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-396-4325
Mailing Address - Street 1:7451 RIVIERA BLVD STE 219
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33023-6572
Mailing Address - Country:US
Mailing Address - Phone:352-396-4325
Mailing Address - Fax:
Practice Address - Street 1:7451 RIVIERA BLVD STE 219
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33023-6572
Practice Address - Country:US
Practice Address - Phone:352-396-4325
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-27
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251C00000X, 251S00000X
251E00000X, 251J00000X, 253Z00000X, 343900000X, 3747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251J00000XAgenciesNursing Care
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)Group - Multi-Specialty
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty