Provider Demographics
NPI:1164145702
Name:STANDING IN THE GAP LLC
Entity Type:Organization
Organization Name:STANDING IN THE GAP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:FORD-BOND
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:419-356-1465
Mailing Address - Street 1:525 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-1094
Mailing Address - Country:US
Mailing Address - Phone:419-360-8251
Mailing Address - Fax:888-422-8961
Practice Address - Street 1:500 MADISON AVE STE 340
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43604-1277
Practice Address - Country:US
Practice Address - Phone:419-360-8251
Practice Address - Fax:888-422-8961
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-20
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility