OrganizationActive
Bridging the Gap With Life Skills
NPI 1659412997 · Emotionally Disturbed Childrens' Residential Treatment Facility · Raleigh, NC
Provider details
- NPI number
- 1659412997
- Entity type
- Organization
- Primary specialty
- Emotionally Disturbed Childrens' Residential Treatment FacilityResidential Treatment Facilities
- Parent organization
- Life Skills Counseling, PLLC
- Authorized official
- Tammy Worthington, Quality Servies Director
- License
- MHL092571 (NC)
Practice location
2507 Blackwolf Run Ln
Raleigh, NC 27604-5425
Phone: (919) 250-9546
Fax: (919) 250-7569
Mailing address
204 N Person St
Raleigh, NC 27601-1047
Registry dates
- Enumerated
- 2007-02-09
- Last updated
- 2007-07-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.