Provider Demographics
NPI:1851931695
Name:BRIDGING THE GAP TREATMENT SERVICES, LLC
Entity Type:Organization
Organization Name:BRIDGING THE GAP TREATMENT SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:LEAH
Authorized Official - Last Name:CARTRETTE-MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:CADC
Authorized Official - Phone:541-408-8023
Mailing Address - Street 1:150 SW 4TH ST
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-1838
Mailing Address - Country:US
Mailing Address - Phone:541-699-6998
Mailing Address - Fax:541-527-4458
Practice Address - Street 1:150 SW 4TH ST
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-1838
Practice Address - Country:US
Practice Address - Phone:541-699-6998
Practice Address - Fax:541-527-4458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-09
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty