Provider Demographics
NPI:1689216574
Name:WATER GAP CAPITAL PARTNERS LLC
Entity Type:Organization
Organization Name:WATER GAP CAPITAL PARTNERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:SCHLIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-524-3039
Mailing Address - Street 1:182 W HILLS RD
Mailing Address - Street 2:
Mailing Address - City:NEW CANAAN
Mailing Address - State:CT
Mailing Address - Zip Code:06840-3028
Mailing Address - Country:US
Mailing Address - Phone:203-524-3039
Mailing Address - Fax:
Practice Address - Street 1:288 MOUNTAIN ROAD
Practice Address - Street 2:
Practice Address - City:DELAWARE WATER GAP
Practice Address - State:PA
Practice Address - Zip Code:18327
Practice Address - Country:US
Practice Address - Phone:203-524-3039
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-11
Last Update Date:2019-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility