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NPI Code Detail

MEDICARE: THE BRADLEY CENTER, INC.

MEDICARE: THE BRADLEY CENTER, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1322D00000XEmotionally Disturbed Childrens' Residential Treatment Facility401010PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1619011269
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE BRADLEY CENTER, INC.
Provider Business Mailing Address
First Line : 5180 CAMPBELLS RUN ROAD
Second Line :
City : PITTSBURGH
State : PA
Zip : 15205-9731
Country : US
Telephone Number : 412-788-8219
Fax Number : 412-788-8215
Provider Business Practice Location Address
First Line : 5180 CAMPBELLS RUN RD
Second Line :
City : PITTSBURGH
State : PA
Zip : 15205-9731
Country : US
Telephone Number : 412-788-8219
Fax Number : 412-809-8200
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : MS. LISA RENE FOX
Credential :
Telephone Number : 412-788-8219
Provider Enumeration Date : 02/16/2007
Last Update Date : 05/04/2011

Similar Medicare Providers

1639023294 — SAMANTHA CATHERINE TRUMPOWER MS
Practice Location Address:
5180 CAMPBELLS RUN RD
PITTSBURGH, PA
15205-9731
Practice Phone: 412-788-8219
Practice Fax:
1437490992 — MR. WILLIAM JOSEPH HOLT LPC
Practice Location Address:
5180 CAMPBELLS RUN RD
PITTSBURGH, PA
15205-9731
Practice Phone: 740-317-8776
Practice Fax:
1851724785 — MR. ROBERT DAVID ZAMBON JR. LCSW
Practice Location Address:
5180 CAMPBELLS RUN RD
PITTSBURGH, PA
15205-9731
Practice Phone: 412-788-8219
Practice Fax: 412-788-8215
1447689096 — DR. BETH BREMNER DNP, FNP-C
Practice Location Address:
5180 CAMPBELLS RUN RD
PITTSBURGH, PA
15205-9731
Practice Phone: 412-788-8219
Practice Fax:
1285033415 — MRS. BAILEY BLEDSOE LPC
Practice Location Address:
5180 CAMPBELLS RUN RD
PITTSBURGH, PA
15205-9731
Practice Phone: 412-788-8219
Practice Fax: 412-788-8215
1669856480 — ROBERT RYAN LPC
Practice Location Address:
5180 CAMPBELLS RUN RD
PITTSBURGH, PA
15205-9731
Practice Phone: 412-788-8219
Practice Fax: 412-788-8215

Directions to “THE BRADLEY CENTER, INC. ” Practice Location

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