Provider Demographics
NPI:1033618574
Name:CLOSING THE GAP, L.L.C.
Entity type:Organization
Organization Name:CLOSING THE GAP, L.L.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ESTHER
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:318-235-0312
Mailing Address - Street 1:951 DITTO RD
Mailing Address - Street 2:
Mailing Address - City:SICILY ISLAND
Mailing Address - State:LA
Mailing Address - Zip Code:71368-4810
Mailing Address - Country:US
Mailing Address - Phone:318-235-0312
Mailing Address - Fax:
Practice Address - Street 1:951 DITTO RD
Practice Address - Street 2:
Practice Address - City:SICILY ISLAND
Practice Address - State:LA
Practice Address - Zip Code:71368-4810
Practice Address - Country:US
Practice Address - Phone:318-235-0312
Practice Address - Fax:318-235-0312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-11
Last Update Date:2018-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty