Provider Demographics
NPI:1457170888
Name:BRIDGING THE GAP
Entity type:Organization
Organization Name:BRIDGING THE GAP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHELSEA
Authorized Official - Middle Name:
Authorized Official - Last Name:YARBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-526-6560
Mailing Address - Street 1:623 MAIN AVE E STE 102
Mailing Address - Street 2:
Mailing Address - City:WEST FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58078-2008
Mailing Address - Country:US
Mailing Address - Phone:701-526-6560
Mailing Address - Fax:
Practice Address - Street 1:623 MAIN AVE E STE 102
Practice Address - Street 2:
Practice Address - City:WEST FARGO
Practice Address - State:ND
Practice Address - Zip Code:58078-2008
Practice Address - Country:US
Practice Address - Phone:701-526-6560
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-03
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty