Provider Demographics
NPI: | 1164227682 |
---|---|
Name: | BRIDGING GAPS THROUGH POSITIVE SOLUTIONS |
Entity type: | Organization |
Organization Name: | BRIDGING GAPS THROUGH POSITIVE SOLUTIONS |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | EXECUTIVE DIRECTOR |
Authorized Official - Prefix: | MRS |
Authorized Official - First Name: | TYRONDA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | MCDERMOTT |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 443-835-4825 |
Mailing Address - Street 1: | 7939 HONEYGO BLVD STE 203 |
Mailing Address - Street 2: | |
Mailing Address - City: | NOTTINGHAM |
Mailing Address - State: | MD |
Mailing Address - Zip Code: | 21236-5992 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 443-835-4825 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 7939 HONEYGO BLVD STE 203 |
Practice Address - Street 2: | |
Practice Address - City: | NOTTINGHAM |
Practice Address - State: | MD |
Practice Address - Zip Code: | 21236-5992 |
Practice Address - Country: | US |
Practice Address - Phone: | 443-835-4825 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2025-02-18 |
Last Update Date: | 2025-03-26 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |