| Bridging The Gap Wellness Center Llc | |
|
2126 Highway 9 E Unit 5b Longs SC 29568-5725 | |
| (478) 361-2126 | |
| Not Available |
| Full Name | Bridging The Gap Wellness Center Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2126 Highway 9 E Unit 5b, Longs, South Carolina |
| Authorized Official Name and Position | Taraka Taylor-moultrie (DIRECTOR) |
| Authorized Official Contact | 4783612126 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bridging The Gap Wellness Center Llc 780 Charter Dr Unit B11 Longs SC 29568-5833 Ph: (478) 361-2126 | Bridging The Gap Wellness Center Llc 2126 Highway 9 E Unit 5b Longs SC 29568-5725 Ph: (478) 361-2126 |
| NPI Number | 1194430660 |
|---|---|
| Provider Enumeration Date | 01/19/2023 |
| Last Update Date | 01/19/2023 |
| Certification Date | 05/24/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194430660 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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