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General NPI Number Information
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NPI Number | 1427113919
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Entity Type | Organization
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Legal Business Name | BRADLEY-REID CORPORATION
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Dates
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Enumeration Date | 12/26/2006
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Last Update Date | 05/13/2011
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Provider Practice Location Address
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Address Line | 715 E 5TH ST STE 216
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City | CHARLOTTE
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State | NC
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Zip | 28202-3001
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Country | US
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Telephone | 704-333-5686
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Fax | 704-376-1931
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Provider Business Mailing Address
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Address Line | 715 E 5TH ST STE 216
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City | CHARLOTTE
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State | NC
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Zip | 28202-3001
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Country | US
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Telephone | 704-333-5686
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Fax | 704-376-1931
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Authorized Official
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Title or Position | CEO CASE MANAGER
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Name | MRS. SANDRA BRADLEY REID
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Credential | M.H.A.
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Telephone | 704-333-5686
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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